Document Detail


Safety of mild hypothermic circulatory arrest with selective cerebral perfusion.
MedLine Citation:
PMID:  19917793     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although hypothermic circulatory arrest with antegrade selective cerebral perfusion is used for cerebral protection, optimal perfusion characteristics are still unclear. Between May 2006 and March 2008, 26 patients (mean age, 68.9 years; 14 males) underwent thoracic aortic repair with mild hypothermic circulatory arrest (34.3 degrees C +/- 1.9 degrees C) and antegrade selective cerebral perfusion (30 degrees C) for various indications including 16 acute type A aortic dissections. Mean cerebral perfusion rate was 21.1 +/- 4.3mL kg(-1) min(-1). Non-elective operations were carried out in 16 (61.5%) cases. Operative procedures were ascending aortic replacement in 16 patients, hemiarch replacement in 4, and total arch replacement in 6. Cardiopulmonary bypass time was 209 +/- 61 min, cardiac ischemic time was 141 +/- 45 min, cerebral perfusion time was 81 +/- 67 min, and lower body circulatory arrest time was 65 +/- 22 min. Mean rectal temperature drifted to 30.6 degrees C +/- 1.3 degrees C. There was 1 (3.8%) hospital death due to rupture of a residual descending thoracic aneurysm. One patient needed reexploration for bleeding, and 2 (7.7%) suffered permanent neurologic dysfunction. No postoperative spinal cord dysfunction was observed. Mild hypothermic circulatory arrest with antegrade selective cerebral perfusion could be performed safely in our patient population.
Authors:
Masashi Toyama; Yasumoto Matsumura; Akinori Tamenishi; Hiroshi Okamoto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  17     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-17     Completed Date:  2010-01-26     Revised Date:  2010-10-20    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  500-4     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Yokkaichi Municipal Hospital, 2-20-37 Shibata, Yokkaichi 510-8567, Japan. machapon@tg.commufa.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aorta, Thoracic / physiopathology,  surgery*
Aortic Diseases / mortality,  physiopathology,  surgery*
Blood Vessel Prosthesis Implantation* / adverse effects
Cardiopulmonary Bypass
Cerebrovascular Circulation*
Female
Heart Arrest, Induced / adverse effects,  methods*
Hospital Mortality
Humans
Hypothermia, Induced* / adverse effects
Male
Middle Aged
Perfusion* / adverse effects
Reoperation
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Asian Cardiovasc Thorac Ann. 2010 Oct;18(5):495   [PMID:  20947611 ]

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