Prospective randomised comparative study of brain unilateral or bilateral antegrade selective cerebral perfusion protection in total aortic arch replacement
- VernacularTitle:单侧与双侧顺行性脑灌注的前瞻性随机对照研究
- Author:
Lizhong SUN
;
Liangxin TIAN
;
Weiping CHENG
- Publication Type:Journal Article
- Keywords:
Cerebrovascular circulation Aorta, thoracic/surgery Neuropsychological tests
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2003;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the cerebral protection effect of unilateral and bilateral antegrade selective cerebral perfusion during total aortic arch replacement. Methods From June 2003 to March 2004, 16 patients undergoing total aortic arch replacement were divided into two groups, randomized: unilateral antegrade selective cerebral perfusion (unilateral group, n=8) and bilateral antegrade cerebral perfusion (bilateral group, n=8). Preoperative and postoperative brain CT scan were performed. During the operation, the pressure in innominate artery and left common carotid artery were monitored. Blood gas samples were drawn from jugular venous bulb. Results There was no postoperative death and all patients were discharged from hospital. No new brain infarction occurred. Transient neurological dysfunction occurred in 1 patient of each group. In unilateral group, the pressure in innominate artery was higher than that in left common carotid artery during antegrade selective cerebral perfusion (P0.05). Conclusion Both methods of brain protection for patients undergoing total aortic arch replacement resulted in favorable levels of mortality and morbidity. The circle of Willis was patent and collateral flow was adequate. Unilateral antegrade selective cerebral perfusion has the advantage of simplicity. The bilateral perfusion pressure was more even in bilateral antegrade selective cerebral perfusion, and whether bilateral antegrade selective cerebral perfusion carry a higher risk of embolism need further investigation.
