Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
Semin Thorac Cardiovasc Surg. 2012 Summer;24(2):123-6. doi: 10.1053/j.semtcvs.2012.01.007.
Historically, reconstruction of the aortic arch has been exclusively performed during deep hypothermic circulatory arrest. Antegrade cerebral perfusion (ACP) has been popularized, offering a more physiologic method of perfusion and extending the safe limits for arch repair. Initially, deep hypothermia has been used as an adjunct to ACP almost universally. More recently, the absolute necessity for deep hypothermia during aortic surgery once ACP with flow rates and pressures within the physiologic range is provided has been questioned from our institution, as well as others. To our best knowledge we have been one of the pioneering centers to start such an aggressive temperature management in aortic arch surgery back in 2000. To date 426 patients underwent aortic arch replacement in our unit employing the standardized surgical protocol described herein.
从历史上看，主动脉弓的重建一直是在深低温停循环下进行的。顺行性脑灌注（ACP）已经得到普及，为灌注提供了一种更符合生理的方法，并扩大了弓部修复的安全范围。最初，深低温几乎普遍被用作 ACP 的辅助手段。最近，从我们的机构以及其他机构提出质疑，在提供了流量和压力均在生理范围内的 ACP 后，主动脉手术是否仍需要深低温。据我们所知，我们是最早在 2000 年开始在主动脉弓手术中采用这种积极的温度管理的先驱中心之一。迄今为止，我们单位共有 426 例患者采用本文所述的标准化手术方案进行主动脉弓置换。
