Key result
Antegrade cerebral perfusion overtakes deep hypothermic circulatory arrest in type A dissection by enabling longer arrest.
Why the study?
Optimal brain protection during surgery for type A aortic dissection is necessary to avoid cerebral damage, with various techniques available and their advantages and limitations needing review.
What are the pros and cons of different brain protection techniques during surgery for type A aortic dissection?
What are the pros and cons of different brain protection techniques during surgery for type A aortic dissection?
Antegrade cerebral perfusion is increasingly preferred over deep hypothermic circulatory arrest for brain protection during type A aortic dissection surgery due to its ability to safely extend arrest times.
Due to the technical necessity to enter the aortic arch during surgery for aortic dissection type A, the brain must be protected optimally to avoid damage to our most precious organ. The different options are reviewed starting with deep hypothermic circulatory arrest which was the first technique described to protect the brain. Its major advantage is the bloodless surgical field and its simplicity but the time constraints limit its application in complex and extended repairs. Therefore antegrade cerebral perfusion has actually become much more popular because this technique allows for much longer arrest periods in which the brain is perfused in a physiological manner reducing the cerebral complications after surgery. Pros and cons of the existing techniques are discussed.
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Schepens et al. (2020) conducted a review in Type A aortic dissection. Brain protection techniques (antegrade cerebral perfusion vs deep hypothermic circulatory arrest) was evaluated. Antegrade cerebral perfusion has become more popular than deep hypothermic circulatory arrest for brain protection during type A aortic dissection surgery as it allows for longer arrest periods.
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