Is It Safe to Initiate Selective Cerebral Perfusion with Normothermia?

Abstract

It may be little dangerous to initiate the SCP with normothermia. P-SCP may be useful in cases in which there is pedunculated atherosclerotic material, or mural thrombus in the ascending and arch aorta.

Two-Step Aortic Cross-Clamping Technique for Acute Type-A Aortic Dissection in Octogenarians

“…Cardiac and clinical situations in end-stage terminal heart failure may require a TAH instead of a biventricular cardiac assist device system [3]. While paracorporeal systems are widely available in cardiothoracic units, a TAH is only available in a limited number of places.…”

“…Our brief experience suggests that surgery for type-A aortic dissection can be safely performed in elderly patients. Short mild hypothermic (32 8C) circulatory arrest with unilateral selective cerebral perfusion is currently a safe method permitting surgery to be carried out inside the aortic arch for a few minutes [3]. Obviously in young patients with acute type-A aortic dissection and involvement of the aortic arch, we opt for a total ascending aorta and arch replacement under moderate hypothermic circulatory arrest with bilateral antegrade cerebral perfusion and open anastomosis.…”