Warm Head - Cool Body in Aortic Arch Surgery – Is It Real?
- #AC/AOR 01-EP-14
- Adult Cardiac Surgery/Aortic. E-POSTER (ORAL) SESSION 1
- E-Poster (oral)
Warm Head - Cool Body in Aortic Arch Surgery – Is It Real?
Evgeny Rosseykin, Michail Evdokimov, Pavel Batrakov, Evgeny Kobzev, Vladlen Bazylev
Federal Center of Cardiovascular surgery, Penza, Russia
Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – C
Abstract
Objective: Usually hypothermia is the main factor for brain protection during the aortic arch surgery. We offer the technique «warm head - cool body» with normothermic total personal brain perfusion.
Materials and methods.From January 2014 to December 2017 94 patients underwent aortic arch surgery. Indications were aneurysm of the aortic arch (n=45, 47,9%), acute dissection (n=21, 22,3%), chronic dissection (n=28, 29,8%).
“Warm brain – cool body” technique includes:
1. Total personal antegrade normothermic cerebral perfusion – we always used all brachiocefalic arteries with the same volume that we measure before CPB in all arch vessels ("Medistim ASA Veri-Q“, Norway);
2. Two independent circuits (two oxygenators) of perfusion (one for body, one for brain);
3. Branch first technique for arch vessels.
Results. 30-day mortality was 2 patients (2.1%). Cardiopulmonary bypass time were 177,3 min (92-113), antegrade selective cerebral perfusion – 144 min (78-220). One patient had a stroke and one - TIA. Mean ICU and total hospital stay were 3 (2-23) and 11 (7-31) respectively.
Conclusions. “Warm brain – cool body” technique for aortic arch reconstruction is a single physiological method (the personal volume through all arch vessels with normothermia) for natural brain perfusion with good clinical results.