Comparative Study of Cerebral Protection during Surgery of Thoracic Aortic Aneurysm

Sueda Taijiro

Nomimura Takayuki

Kagawa Tetsuya

Morita Satoru

Hayashi Saiho

Orihashi Kazumasa

Shikata Hiroo

Ryuu Gou

Hamanaka Yoshiharu

Matsuura Yuichiro

Kawaue Yasushi

Kanehiro Keiichi

Ishihara Hiroshi

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

During the past 5 years, 30 cases of thoracic aortic aneurysm were treated. Selective cerebral perfusion (SCP) and retrograde cerebral perfusion (RCP) were conducted for cerebral protection during aortic cross clamping. SCP was carried out in 5 cases of dissecting aneurysm (all Stanford type A, including a case of AAE) and 3 cases of arch aneurysm. RCP was conducted in 5 cases of dissecting aneurysm (4 Stanford type A; 1 Stanford type B with retrograde dissection) and 2 cases of aortic arch aneurysm. The mean cerebral perfusion time of SCP exceeded that of RCP (89 ± 26 min in SCP versus 61 ± 33 min in RCP p < 0.05). The hospital mortality rate was 38 % (SCP) and 29% (RCP). Neurological complications were prolonged unconsciousness (1/8 in SCP, 1/7 in RCP) and transient paralysis (0/8 in SCP, 1/7 in RCP). Although the mechanism for the cerebral protective effect of RCP is unknown, this perfusion method is easy and safe, requiring little time for ascending and/or arch aortic reconstruction.

Ascending and arch aortic aneurysm

Selective cerebral perfusion

Retrograde cerebral perfusion

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

[ISSN] 0018-2052

[NCID] AA00664312

[PMID] 1286973