Konferenzpaper

Jahr der Veröffentlichung: 1998

Seiten: 7-11

Zeitschrift: The Thoracic and Cardiovascular Surgeon

Bandnummer: 46

Heftnummer: 1

ISSN: 0171-6425

eISSN: 1439-1902

DOI Link: https://doi.org/10.1055/s-2007-1010176

Konferenz: German/Turkish Joint Symposium on Cardiovascular Surgery and Cardiology

Verlag: Thieme Publishing / Georg Thieme Verlag

Abstract: 
Maintaining an adequate cerebral oxygen supply is a serious problem in aortic arch surgery. Deep hypothermic circulatory arrest is the most common method used for cerebral protection, but guarantees only a time-limited safety period. Based on experimental investigations, we applied selective cerebral perfusion via the innominate artery alone with only moderate hypothermia (28 degrees C) and without circulatory arrest in 25 consecutive patients undergoing surgical treatment of an aneurysm (n = 10) or acute type-A dissection (n = 15) involving the aortic valve and arch. In every case a test perfusion was carried out to assess whether the cerebral perfusion achieved would be adequate for the whole operation. In no case was the perfusion inadequate. As a new perioperative monitoring system, we used computer-aided topographical electroencephalometry (CATEEM). There were 18 male and 7 female patients, their age was 47.0 +/- 15.1 years (mean +/- SD). Mean time periods were 155.1 +/- 37.3 min for aortic cross-clamping, and 69.3 +/- 35 min for selective cerebral perfusion. Postoperatively, two patients (8%) revealed a temporary left-sided hemiparesis, and 4 patients (16%) died within 30 days. The overall mortality rate was 16% in a follow-up period of 24.2 +/- 9.5 months. In this small group the CATEEM monitoring enabled an intraoperative selection of patients with sufficient bihemispheric collateral circulation and therefore suitable for simple innominate artery perfusion.

Harvard-Zitierstil: Wozniak, G., Dapper, F., Schindler, E., Akinturk, H., Zickmann, B., Gehron, J., et al. (1998) An assessment of selective cerebral perfusion via the innominate artery in aortic arch replacement, The Thoracic and Cardiovascular Surgeon, 46(1), pp. 7-11. https://doi.org/10.1055/s-2007-1010176

APA-Zitierstil: Wozniak, G., Dapper, F., Schindler, E., Akinturk, H., Zickmann, B., Gehron, J., & Hehrlein, F. (1998). An assessment of selective cerebral perfusion via the innominate artery in aortic arch replacement. The Thoracic and Cardiovascular Surgeon. 46(1), 7-11. https://doi.org/10.1055/s-2007-1010176