Hybrid cerebral perfusion in aortic arch surgery: Bridging antegrade and retrograde techniques

Figures

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  Total/partial arch replacement volume with stroke and operative mortality trends.

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  Figure 1. Unilateral (A) and bilateral (B) antegrade cerebral perfusion.

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  Figure 2. Retrograde cerebral perfusion.

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  Figure 3. The annual number of total/partial arch replacement cases and trend over the years.

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  Figure 4. Temporal trends in postoperative stroke (A) and operative mortality (B) across the study years among patients undergoing total/partial arch replacement at our institution.

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  Figure E1. A schematic overview of total/partial arch replacement, including a detailed timeline of perfusion transitions and a general workflow of the procedure, the sequence of cannulation, initiation of cerebral perfusion, and head vessel reimplantation for each strategy (DHCA alone, retrograde-only, antegrade-only, and hybrid), is provided. DHCA, Deep hypothermic circulatory arrest; RCP, retrograde cerebral perfusion; ACP, antegrade cerebral perfusion; CPB, cardiopulmonary bypass; EEG, electroencephalography; LCCA, left common carotid artery; SVC, superior vena cava.