Cardiovascular Surgery Department, Yuksek Ihtisas Hospital of Turkey, Ankara, Turkey.
Eur J Cardiothorac Surg. 2010 Mar;37(3):669-76. doi: 10.1016/j.ejcts.2009.09.011. Epub 2009 Oct 6.
This study investigates distal organ protection during moderately hypothermic right brachial artery selective antegrade cerebral perfusion (MHSACP) in patients undergoing aortic arch repair.
Fifty patients undergoing ascending aorta/aortic arch repair using the MHSACP technique (study group) were compared with another 50 patients randomly selected amongst those undergoing moderately hypothermic open heart procedures (control group). The data from successive clinical examinations and blood samplings were then compared to detect any sign of distal organ damage attributable to the MHSACP technique.
The mortality rate did not differ between the two groups (2%). The average cardiopulmonary bypass and aortic cross-clamping durations were 154+/-53 min versus 102+/-25 min and 101+/-41 min versus 70+/-31 min for the study and control groups, respectively. The mean MHSACP period was 32+/-14 min (11-81 min) in the study group. The average discharge time was 6.4+/-1.4 days (5-12 days). Repeated clinical examinations revealed no organ dysfunction and there was no difference between the two groups (with the exception of lactate dehydrogenase) with regard to compared biochemical markers, which might be suggestive of a visceral damaging effect of the MHSACP technique.
The present data show that with the use of MHSACP, distal organs are relatively well protected during aortic arch repairs.
本研究旨在探讨在主动脉弓修复术中使用中度低温右侧肱动脉选择性顺行脑灌注（MHSACP）时对远端器官的保护作用。
将 50 例行升主动脉/主动脉弓修复术并使用 MHSACP 技术的患者（研究组）与随机选择的 50 例行中度低温体外循环心脏手术的患者（对照组）进行比较。然后比较连续临床检查和血液采样的数据，以检测归因于 MHSACP 技术的任何远端器官损伤迹象。
两组死亡率无差异（2%）。研究组的体外循环和主动脉阻断时间分别为 154+/-53 分钟和 101+/-41 分钟，对照组分别为 102+/-25 分钟和 70+/-31 分钟。研究组 MHSACP 期间的平均时间为 32+/-14 分钟（11-81 分钟）。平均出院时间为 6.4+/-1.4 天（5-12 天）。重复的临床检查未发现器官功能障碍，两组之间在比较的生化标志物方面没有差异（除了乳酸脱氢酶），这可能表明 MHSACP 技术对内脏有损害作用。
本研究数据表明，在主动脉弓修复术中使用 MHSACP 可以相对较好地保护远端器官。
