ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Marc A.A.M. Schepens
Karl M. Dossche
Roberto Di Bartolomeo
Davide Pacini
Angelo Pierangeli
Teruhisa Kazui
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Di Eusanio, M.
Right arrow Articles by Washiyama, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Di Eusanio, M.
Right arrow Articles by Washiyama, N.
Related Collections
Right arrow Cerebral protection

Ann Thorac Surg 2003;76:1181-1189
© 2003 The Society of Thoracic Surgeons

Original article: cardiovascular

Brain protection using antegrade selective cerebral perfusion: a multicenter study

Marco Di Eusanio, MDa*, Marc A.A.M. Schepens, MD, PhDa, Wim J. Morshuis, MD, PhDa, Karl M. Dossche, MD, PhDa, Roberto Di Bartolomeo, MDb, Davide Pacini, MDb, Angelo Pierangeli, MDb, Teruhisa Kazui, MDc, Kazuhiro Ohkura, MDc, Naoki Washiyama, MDc

a Department of Cardiopulmonary Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
b Department of Cardiac Surgery, Policlinico S Orsola, University of Bologna, Bologna, Italy
c First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan

* Address reprint requests to Dr Di Eusanio, Dipartimento di Cardiochirurgia, Ospedale Cardiologico "GM Lancisi," Via Baccarani 6, Ancona, 60122, Italy.
e-mail: m_dieus{at}hotmail.com

Presented at the Thirty-ninth Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 31–Feb 2, 2003.

BACKGROUND: To evaluate the results of antegrade selective cerebral perfusion as a method of brain protection during surgery of the thoracic aorta and to determine predictors of hospital mortality and adverse neurologic outcome.

METHODS: Between October 1995 and March 2002, 588 patients underwent aortic surgery with the aid of antegrade selective cerebral perfusion. There were 334 men (56.8%); the mean age was 63.7 ± 11.8 years. One hundred sixty-two patients (27.6%) underwent urgent operation. The separated graft technique was employed to reimplant the arch vessels in 230 patients (65.3%) of the 352 requiring aortic arch replacement. Associated procedures were performed in 254 patients (43.2%). One hundred twelve patients underwent elephant trunk procedure. The mean cerebral perfusion time was 67 ± 37 minutes.

RESULTS: The overall hospital mortality rate was 8.7%. A logistic regression analysis revealed urgent operation, recent central neurologic event, tamponade, unplanned coronary artery revascularization and pump time to be independent predictors of hospital mortality (p < 0.05). The permanent neurologic dysfunction rate was 3.8%. A logistic regression analysis showed tamponade to be independent predictor of permanent neurologic dysfunction (p < 0.05). The transient neurologic dysfunction rate was 5.6%. Recent central neurologic event, tamponade, coronary disease, and aortic valve replacement were indicated as independent predictors of transient neurologic dysfunction by logistic regression (p < 0.05).

CONCLUSIONS: In our experience the utilization of antegrade selective cerebral perfusion resulted in encouraging results in terms of hospital mortality and brain complications. Neither the extent of the replacement nor the duration of the cerebral perfusion had an impact on hospital mortality and neurologic outcome.




This article has been cited by other articles:


Home page
 Asian Cardiovasc. Thorac. Ann.Home page
M. Toyama, Y. Matsumura, A. Tamenishi, and H. Okamoto
Safety of Mild Hypothermic Circulatory Arrest with Selective Cerebral Perfusion
Asian Cardiovasc Thorac Ann, October 1, 2009; 17(5): 500 - 504.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Khoynezhad and R. Celis
Transcranial Doppler-guided selective antegrade cerebral perfusion during aortic debranching operation
J. Thorac. Cardiovasc. Surg., October 1, 2009; 138(4): 1029 - 1030.
[Full Text] [PDF]

Home page
 ICVTSHome page
P. G. Malvindi, G. Scrascia, and N. Vitale
Is unilateral antegrade cerebral perfusion equivalent to bilateral cerebral perfusion for patients undergoing aortic arch surgery?
Interactive CardioVascular and Thoracic Surgery, October 1, 2008; 7(5): 891 - 897.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. C. Halstead, M. Meier, M. Wurm, N. Zhang, D. Spielvogel, D. Weisz, C. Bodian, and R. B. Griepp
Optimizing selective cerebral perfusion: Deleterious effects of high perfusion pressures.
J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 784 - 791.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
N. Khaladj, M. Shrestha, S. Meck, S. Peterss, H. Kamiya, K. Kallenbach, M. Winterhalter, L. Hoy, A. Haverich, and C. Hagl
Hypothermic circulatory arrest with selective antegrade cerebral perfusion in ascending aortic and aortic arch surgery: A risk factor analysis for adverse outcome in 501 patients.
J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 908 - 914.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
T. Kunihara, N. Shiiya, K. Matsuzaki, and Y. Matsui
Metabolic relevance during isolation technique in total arch repair for patients at high risk with embolic stroke
Interactive CardioVascular and Thoracic Surgery, February 1, 2008; 7(1): 58 - 62.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
R. Pretre and M. I. Turina
Deep Hypothermic Circulatory Arrest
Card. Surg. Adult, January 1, 2008; 3(2008): 431 - 442.
[Full Text]

Home page
 Card Surg AdultHome page
D. Spielvogel, M. N. Mathur, and R. B. Griepp
Aneurysms of the Aortic Arch
Card. Surg. Adult, January 1, 2008; 3(2008): 1251 - 1276.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
J. C. Halstead, C. Etz, D. M. Meier, N. Zhang, D. Spielvogel, D. Weisz, C. Bodian, and R. B. Griepp
Perfusing the Cold Brain: Optimal Neuroprotection for Aortic Surgery
Ann. Thorac. Surg., September 1, 2007; 84(3): 768 - 774.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. Dahlbacka, H. Alaoja, J. Makela, E. Niemela, P. Laurila, K. Kiviluoma, A. Honkanen, P. Ohtonen, V. Anttila, and T. Juvonen
Effects of pH Management During Selective Antegrade Cerebral Perfusion on Cerebral Microcirculation and Metabolism: Alpha-Stat Versus pH-Stat
Ann. Thorac. Surg., September 1, 2007; 84(3): 847 - 855.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Pacini, A. Leone, L. Di Marco, D. Marsilli, F. Sobaih, S. Turci, V. Masieri, and R. Di Bartolomeo
Antegrade selective cerebral perfusion in thoracic aorta surgery: safety of moderate hypothermia
Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 618 - 622.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Mazzola, R. Gregorini, C. Villani, L. B. Colantonio, R. Giancola, G. L. Gravina, and C. Vicentini
Cavoatrial Tumor Thrombectomy With Systemic Circulatory Arrest and Antegrade Cerebral Perfusion
Ann. Thorac. Surg., April 1, 2007; 83(4): 1564 - 1565.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Gulbins, A. Pritisanac, and J. Ennker
Axillary Versus Femoral Cannulation for Aortic Surgery: Enough Evidence for a General Recommendation?
Ann. Thorac. Surg., March 1, 2007; 83(3): 1219 - 1224.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Spielvogel, C. D. Etz, D. Silovitz, S. L. Lansman, and R. B. Griepp
Aortic Arch Replacement With a Trifurcated Graft
Ann. Thorac. Surg., February 1, 2007; 83(2): S791 - S795.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. K. Harrington, F. Fragomeni, and R. S. Bonser
Cerebral Perfusion
Ann. Thorac. Surg., February 1, 2007; 83(2): S799 - S804.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Sasaki, H. Ogino, H. Matsuda, K. Minatoya, M. Ando, and S. Kitamura
Integrated Total Arch Replacement Using Selective Cerebral Perfusion: A 6-Year Experience
Ann. Thorac. Surg., February 1, 2007; 83(2): S805 - S810.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. M. Budde, D. L. Serna Jr, S. C. Osborne, M. A. Steele, and E. P. Chen
Axillary Cannulation for Proximal Aortic Surgery is as Safe in the Emergent Setting as in Elective Cases
Ann. Thorac. Surg., December 1, 2006; 82(6): 2154 - 2160.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Della Corte, M. Scardone, G. Romano, C. Amarelli, A. Biondi, L. S. De Santo, M. De Feo, G. Nappi, and M. Cotrufo
Aortic Arch Surgery: Thoracoabdominal Perfusion During Antegrade Cerebral Perfusion May Reduce Postoperative Morbidity
Ann. Thorac. Surg., April 1, 2006; 81(4): 1358 - 1364.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Olsson and S. Thelin
Antegrade Cerebral Perfusion With a Simplified Technique: Unilateral Versus Bilateral Perfusion
Ann. Thorac. Surg., March 1, 2006; 81(3): 868 - 874.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Pacini, M. Bergonzini, A. Loforte, G. Gargiulo, E. Pilato, and R. Di Bartolomeo
Aneurysms After Coarctation Repair Associated With Hypoplastic Aortic Arch: Surgical Management Through Median Sternotomy
Ann. Thorac. Surg., February 1, 2006; 81(2): 758 - 760.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. C. Halstead, D. Spielvogel, D. M. Meier, D. Weisz, C. Bodian, N. Zhang, and R. B. Griepp
Optimal pH strategy for selective cerebral perfusion
Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 266 - 273.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. T. Strauch, D. Spielvogel, A. Lauten, N. Zhang, S. Rinke, D. Weisz, C. A. Bodian, and R. B. Griepp
Optimal temperature for selective cerebral perfusion
J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 74 - 82.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
R.S. Bonser and D.K. Harrington
Editorial comment
Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 102 - 103.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
U. Karadeniz, O. Erdemli, M. A. Ozatik, B. Yamak, A. Demirci, S. A. Kucuker, A. Saritas, and O. Tasdemir
Assessment of Cerebral Blood Flow With Transcranial Doppler in Right Brachial Artery Perfusion Patients
Ann. Thorac. Surg., January 1, 2005; 79(1): 139 - 146.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
O. Reuthebuch, U. Schurr, J. Hellermann, R. Pretre, A. Kunzli, M. Lachat, and M. I. Turina
Advantages of subclavian artery perfusion for repair of acute type A dissection
Eur. J. Cardiothorac. Surg., September 1, 2004; 26(3): 592 - 598.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2003 by The Society of Thoracic Surgeons.