Key result
Adjunctive cerebral protective techniques, including hypothermic circulatory arrest and cerebral perfusion, are discussed to counteract the high risk of brain injury during aortic arch surgery.
This review outlines the risk factors for neurological complications during aortic arch surgery and discusses the relative merits of various cerebral protective techniques.
Should not yet change aortic arch surgery practice; leaves open optimal cerebral protection technique selection.
Surgery of the aortic arch involves an inherently high risk of neurological complications. A number of factors have been identified which may predispose the patient to brain injury, and various techniques employed in an attempt to counteract these are outlined. In particular the vulnerability of the brain to ischemia has led to the development of three adjunctive cerebral protective techniques, hypothermic circulatory arrest, retrograde cerebral perfusion and selective antegrade cerebral perfusion, all based upon brain cooling and metabolic inhibition. The relative merits and disadvantages of these techniques are therefore discussed. Finally, pharmacologic adjuncts and potential future developments in aortic arch surgery are discussed.
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Harrington et al. (2002) conducted a review in Neurological complications of aortic surgery. Adjunctive cerebral protective techniques (hypothermic circulatory arrest, retrograde cerebral perfusion, selective antegrade cerebral perfusion) was evaluated. Adjunctive cerebral protective techniques, including hypothermic circulatory arrest and cerebral perfusion, are discussed to counteract the high risk of brain injury during aortic arch surgery.
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