The study on perfusion flow of cardiopulmonary bypass during acute Stanford type A aoritc dissection procedure / 中华胸心血管外科杂志

ABSTRACT

Objective To research the reasonable perfusion flow of cardiopulmonary bypass during aortic arch procedure of patients with acute type A aortic dissection.Methods Forty patients suffered from acute Stanford type A aortic dissection had been divided into two groups randomly.Group A named traditional perfusion flow group,group B named modified perfusion flow group.Monitoring cerebral blood flow and cerebral tissue oxygen during deep hyperthermia circulatory arrest and antegrade aelective cerebral perfusion procedure by transcranial doppler(TCD) and near-infrared spectroscopy(NIRS).The concentration of S100 protein and lactic acid was measured at six time point.Results Statistical difference of mean blood flow velocity of MCA had been found between two group 3 min after total flow reperfusion.TOI was more tban 60％ during study in both of groups.S100 protein in group A was significantly higher than group B at T6,T7 and T8.Statistical difference of blood lactic concentration had been found between two groups,(4.88± 1.62) mmol/L in group A,(3.83± 1.48) mmol/L in group B,P ＜ 0.05.Safe consciousness time between two groups was difference,(7.36± 2.86) h in group A and (5.27± 3.11) h in group B,P ＜ 0.05.Conclusion Compared with the traditional perfusion flow,modified perfusion flow can provide sufficient cerebral perfusion and prevent the luxury perfusion.