Aortic arch reconstruction using regional perfusion without circulatory arrest

Abstract

Regional perfusion is feasible and can be used with acceptable results. It may reduce potential complications following aortic arch reconstruction using circulatory arrest. However, repair of aortic arch in the patients with complex intracardiac defects still imposes a significant rate of mortality and morbidity.

Repair of the symptomatic aberrant aortic arch aneurysm without hypothermic circulatory arrest

“…The conduct of CPB without any period of hypothermic circulatory arrest may prove to be a useful technique in many cases of aortic arch surgery. Double cannulation of the ascending aorta and the innominate artery for arch reconstruction in an infant was recently reported [8]. In that case the cannulation technique afforded regional perfusion of the brachiocephalic vessels.…”

Is unilateral brain regional perfusion neurologically safe during congenital aortic arch surgery?

“…Regional brain perfusion was introduced to avoid the neurological complications associated with circulatory arrest method [2][3][4][5][6][7].…”

Hypothermic extracorporeal circulation in immature swine: a comparison of continuous cardiopulmonary bypass, selective antegrade cerebral perfusion and circulatory arrest☆

“…Table 3 depicts the median regional histologic scores, NDS and OPC on POD 1. The median THS was 9 (range 0-11) for the FF group, 12 (range [4][5][6][7][8][9][10][11][12][13][14] for the HCA group and 9 (range 0-11) for the SCP group ( p = NS). Histopathologic changes were found in all groups.…”

“…Such changes have been attributed to the hypoxic-ischaemic injury and the vulnerability of the neonatal blood-brain barrier, cerebral white matter and germinal matrix [10]. Selective antegrade cerebral perfusion (SCP) has been employed to provide cerebral blood flow during HCA in aortic arch operations for adults as well as neonates [11,12,17]. While SCP theoretically affords some degree of neuroprotection to the patient, there are limited data to substantiate this claim [2,3,9,14,15].…”