Comparison of the brain protection effect of unilateral or bilateral selective cerebral perfusion in total aortic arch replacement / 解放军医学杂志

ABSTRACT

Objective To compare the brain protection effect of unilateral and bilateral selective cerebral perfusion (SCP) techniques in patients undergoing total aortic arch replacement for DeBakey type I aortic dissecting aneurysm. Methods Twentyfour patients from Dec. 2013 to Dec. 2014 in General Hospital of PLA who underwent total aortic arch replacement were divided into two groups: unilateral SCP group (USCP group, n=16) and bilateral SCP group (BSCP group, n=8), according to different brain protective techniques applied during deep hypothermia and circulatory arrest. Preoperative and postoperative neurological examinations and brain CT scans were performed in two groups. During the operation, the cerebral oxygen saturation of patients was continuously monitored. The occurrence of postoperative temporary neurological dysfunction (TND) of all patients was observed and recorded. Results After the operation, all patients recovered smoothly. Three patients suffered from postoperative TND in the USCP group and 1 patient in the BSCP group. Preoperative and postoperative brain CT scans showed no significant difference between two groups. Also there was no intergroup difference in the cerebral oxygen saturation of patients (P>0.05). Conclusion In the surgery of total aortic arch replacement, the technique for unilateral selective cerebral perfusion is easy to perform, feasible, and effective on the protection of the brain in patients suffering from DeBakey type I aortic dissecting aneurysm.