Clinical Result of Aortic Arch Replacement using Antegrade Brain Perfusion Via Right Axillary Artery / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Cerebral protection is one of the most important procedures during aortic arch surgery. We can minimize neurological complications through short period of total circulatory arrest and resuming of brain perfusion. We evaluated 11 patients who underwent arch replacement using antegrade brain perfusion via right axillary artery. MATERIAL AND METHOD: Between July 2004 and July 2006, 11 patients (male 9, female 2) underwent aortic arch replacement with antegrade brain perfusion via right axillary artery. Preoperative diagnosis was listed; 5 type A aortic dissections (5/11, 45.5%), 5 aortic aneurysms (5/11, 45.5%) and 1 type A IMH (intramural hematoma, 1/11, 9%). The mean age at the time of operation was 60.3+/-12.8 years. For antegrade brain perfusion, we performed right axillary artery cannulation in all patients. Retrograde brain perfusion was used briefly during total circulatory arrest. RESULT: The mean total circulatory arrest time was 31.1+/-16.9 minutes and the mean retrograde brain perfusion time was 21+/-17.8 minutes. Mean antegrade brain perfusion time was 77.9+/-17.5 (43~101) minutes. We had neither operative mortality nor permanent neurological complications. CONCLUSION: By means of antegrade brain perfusion via right axillary artery, that could lead to decrease circulatory arrest time and minimize damages to severely atheromatous arch vessels, we can expect to reduce neurological complications after aortic arch replacement. Further investigation with large patient populations will be required.