| Selective Cerebral Perfusion Through the Right Axillary Artery for Aortic Arch Replacement: A Case Report. |
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Yoo Sung Jeong, Chang Sik Choi, Younsuk Lee, Jun Heum Yon |
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Department of Anesthesiology, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. |
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| Abstract |
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To prevent ischemic brain damage, different techniques, such as, the deep hypothermic circulatory arrest (DHCA), selective antegrade cerebral perfusion (SACP) and retrograde cerebral perfusion (RCP), have been widely used in patients undergoing aortic arch replacement. However, these techniques have been reported to have potential hazards, and in these techniques. Coagulation defect, atheremboli and cerebral edema are known to lead to neuropsychological deficits after cardiopulmonary bypass (CPB). We believe that cerebral perfusion through the right axillary artery, modification of SACP, is the safer, more physiologic and feasible technique. Selective cerebral perfusion (flow: 8-10 mL/kg/min) by right axillary artery cannulation during deep hypothermic arrest was applied in two male patients; a 71-year-old male with ascending aortic aneurysm and a 76-year-old male with aortic dissection (Stanford type A).
Both operations were successful and no neurologic complication occurred postoperatively. |
| Key Words:
Cardiopulmonary bypass; selective cerebral perfusion; axillary artery cannulation |
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