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Ann Thorac Surg 2007;83:S799-S804
© 2007 The Society of Thoracic Surgeons

Supplement

Cerebral Perfusion

Deborah K. Harrington, MB, MRCS, Fernanda Fragomeni, Robert Stuart Bonser, MD, FRCS*

Department of Cardiac Surgery, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham, United Kingdom

Accepted for publication November 2, 2006.

* Address correspondence to Dr Bonser, Department of Cardiac Surgery, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham B15 2TH, United Kingdom. (Email: robert.bonser{at}uhb.nhs.uk).

Presented at Aortic Surgery Symposium X, New York, NY, April 27–28, 2006.

Aortic arch surgery necessitates interrupted brain perfusion and carries a risk of brain injury. Various brain protective techniques have been advocated to reduce risk including hypothermic arrest and retrograde or selective antegrade perfusion. Knowledge of the pathophysiologic consequences of deep hypothermia, may aid the surgeon in deciding when to initiate circulatory arrest and for how long. Retrograde cerebral perfusion use was advocated to prolong safe arrest durations but may not improve outcomes. Selective antegrade cerebral perfusion appears to have become the preferred method of brain protection. However, the delivery conditions and optimal perfusate constitution require further study.




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