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Low-flow perfusion technique for shaggy aortic arch.
- Source :
-
General thoracic and cardiovascular surgery [Gen Thorac Cardiovasc Surg] 2024 Jul; Vol. 72 (7), pp. 439-446. Date of Electronic Publication: 2023 Nov 23. - Publication Year :
- 2024
-
Abstract
- Background: The most common complication of thoracic aortic disease with shaggy aorta is cerebral infarction. We have performed "low-flow perfusion" as a method of extracorporeal circulation to prevent cerebral embolism in patients with strong atherosclerotic lesions in the aortic arch.<br />Methods: "Low-flow perfusion" is a method in which cardiopulmonary bypass is started by partial blood removal, approaching deep hypothermia while maintaining self-cardiac output. We compared the outcomes of 12 patients who underwent the "low-flow perfusion" method (Group L) with those of 12 who underwent normal extracorporeal circulation (Group N) during aortic arch surgery since 2019.<br />Results: Group L consisted of 8 males with an average age of 73 years old, and Group N consisted of 6 males with an average age of 73 years old. The average time from the start of cooling to ventricular fibrillation was 9.5 min in Group L and 3.6 min in Group N (pā<ā0.01). The eardrum temperature when ventricular fibrillation was reached was 28.2 °C in Group L and 32.5 °C in Group N (pā=ā0.01). A blood flow analysis also revealed low wall shear stress on the lesser curvature of the aortic arch.<br />Conclusion: With this method, the intracranial temperature was sufficiently low at the time of ventricular fibrillation, and there was no need to increase the total pump flow. The low-flow perfusion method can prevent cerebral embolism by preventing atheroma destruction by the blood flow jet while maintaining the self-cardiac output during the cooling process.<br /> (© 2023. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.)
- Subjects :
- Humans
Male
Aged
Treatment Outcome
Cardiopulmonary Bypass methods
Aortic Diseases surgery
Aortic Diseases physiopathology
Intracranial Embolism prevention & control
Intracranial Embolism etiology
Intracranial Embolism physiopathology
Middle Aged
Aged, 80 and over
Regional Blood Flow
Aorta, Thoracic surgery
Aorta, Thoracic physiopathology
Aorta, Thoracic diagnostic imaging
Perfusion methods
Subjects
Details
- Language :
- English
- ISSN :
- 1863-6713
- Volume :
- 72
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- General thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 37995016
- Full Text :
- https://doi.org/10.1007/s11748-023-01988-7