Neuro-protection in open arch surgery

Cerbral Protection Strategies for Aortic Arch Surgery

Surgical therapy for aortic arch disease involves partial or complete replacement of the aortic arch with reimplantation of the great vessels while the cerebral blood flow is temporarily altered. Patients undergoing this mandatory period of circulatory arrest during arch replacement are at an increased risk for adverse neurologic outcomes, and strategies for cerebral protection must be implemen...

Cerebral protection during aortic arch surgery.

Anesthesia in Cardiac Surgery (Open-Closed Heart)

In this paper the duties of an anesthesiologist and his right of i=;electing patient is discussed. La,ter, we di:=:cuss the <::mergencies cf heart surgery, pre up visit and alsc few dcails of pre up medication cf thei,e pati<mts. We also touch on the stages of anesthPsia and point to our preference for the use cf artery and vein for arterial and venous cannulation. In this paper we discuss in b...

Open aortic arch reconstruction.

Aortic arch reconstruction remains a formidable operative procedure. Pioneering work by DeBakey et al. in 1957 identified neurological complications as a predominant cause of high mortality rate (1). The introduction of deep hypothermic circulatory arrest (HCA) by Griepp et al. simplified the operative approach and established a safe strategy for neuroprotection (2). Seminal work by Crawford an...

Best strategy for cerebral protection in arch surgery - antegrade selective cerebral perfusion and adequate hypothermia.

Aortic arch surgery remains a complex surgical operation that necessitates specific neuroprotection strategies. Various approaches, such as hypothermic circulatory arrest (HCA), retrograde cerebral perfusion, and antegrade selective cerebral perfusion (aSCP), have each enjoyed periods of popularity. However, while the overall surgical approach tend to favour HCA with aSCP, technical factors, su...