Unilateral versus bilateral cerebral perfusion in deep hypothermia circulatory arrest surgery
10.3760/cma.j.issn.1001-4497.2010.01.008
- VernacularTitle:单、双侧顺行脑灌注在主动脉病变深低温停循环手术中的效果比较
- Author:
Zhiwei WANG
;
Xiaoping HU
;
Hongbing WU
;
Hongping DENG
;
Luocheng LI
;
Jiale OU
- Publication Type:Journal Article
- Keywords:
Aorta diseases;
Phosphopyruvatc hydratase;
Cardiopulmonary bypass;
Antegrade cerebral per-fusion;
S-100β protein
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2010;26(1):20-22
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the applicability of unilateral and bilateral antegrade cerebral perfusion during deep hy-potbermia circulatory arrest (DHCT) surgery and to determine a better method of brain protection. Methods 60 patients un-derwent aortic arch surgery were random divided into either unilateral cerebral perfusion group with a cannula in the innominate artery (n = 30 ) , or bilateral cerebral peffusion gToup with an additional cannula in the left carotid artery ( n = 30 ). S-100β,neuron specific enolase (NSE) were assayed at the following time points: the beginning of cardiopulmonary bypass (T_1), the beginning of circulatory arrcst( T_2 ), antegradc cerebral perfusion (ACP) 25 min( T_3 ), the end of ACP( T_4 ), the end of car-diopulmonary bypass ( T_5 ) , 1h( T_6 ) , 6h ( T_7 ) and 24h( T_8 ) after operation. Neurological deficit incidence and mortality were also obtained. Results There is no statistical significance for S-100β and NSE plasma concentration among time points of T_1、T_2 and T_3. But every time point among T_4、T_5、T_6、T_7 ,Ts do have statistical significances. The incidence of central nervous system dysfunction in group unilateral ACP was higher than that in group bilateral ACP ( 33.33% vs. 10.00%, P = 0.028 ).But there is no significant difference between the two groups in mortality( 3.33% vs. 6.66% ,P = 1. 000 ). Conclusion There is no significant difference between unilateral ACP and bilateral ACP in 25 min during DHCA. But as the DHCA time extends, the effect of bilateral ACP will be better.
