Key result
Cerebral perfusion strategies in aortic arch surgery require randomized trials to define the optimal approach.
Why the study?
Controversy remains regarding the optimal cerebral protection strategy during aortic arch surgery despite recent advancements.
This review highlights the ongoing controversy regarding optimal cerebral protection strategies in aortic arch surgery and emphasizes the need for randomized clinical trials.
Absence of RCT data precludes definitive recommendations for cerebral perfusion in aortic arch surgery; leaves open the optimal strategy.
Although significant advancements in cerebral protection strategies in aortic surgery have been achieved in recent years, controversy remains on what constitutes the optimal strategy. Deep hypothermic circulatory arrest alone is a viable approach in many instances, but the need for a prolonged duration of circulatory arrest and increasing case complexity have led to the utilization of adjunctive cerebral perfusion strategies. In this review, we discuss the efficacy of deep hypothermic circulatory arrest and its limitations, the role of retrograde cerebral perfusion and unilateral and bilateral antegrade cerebral perfusion, and the trend towards goal-directed perfusion strategies, all emphasizing the pressing need for randomized clinical trials to better define the optimal strategy.
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Lou et al. (2020) conducted a review in Aortic arch surgery. Cerebral perfusion strategies was evaluated. This review discusses various cerebral perfusion strategies in aortic arch surgery, emphasizing the pressing need for randomized clinical trials to define the optimal approach.
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