开放弓手术中的神经保护
Neuro-protection in open arch surgery.
作者信息
Okita Yutaka
机构信息
Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
Ann Cardiothorac Surg. 2018 May;7(3):389-396. doi: 10.21037/acs.2018.04.01.
Abstract
Although antegrade cerebral perfusion (ACP) is the predominant method of protecting the brain in patients undergoing total arch replacement, both deep hypothermic circulatory arrest and ACP provide excellent and comparable clinical outcomes with regard to mortality, stroke, and temporary neurological deficit rates.
摘要
尽管顺行性脑灌注（ACP）是全弓置换患者脑保护的主要方法，但在死亡率、中风和短暂性神经功能缺损发生率方面，深低温停循环和ACP均能提供出色且相当的临床结果。
相似文献
1
Neuro-protection in open arch surgery.开放弓手术中的神经保护
Ann Cardiothorac Surg. 2018 May;7(3):389-396. doi: 10.21037/acs.2018.04.01.
2
Simple retrograde cerebral perfusion is as good as complex antegrade cerebral perfusion for hemiarch replacement.对于半弓置换，简单的逆行脑灌注与复杂的顺行脑灌注效果相当。
J Vis Surg. 2018 Mar 13;4:50. doi: 10.21037/jovs.2018.02.10. eCollection 2018.
3
Retrograde and antegrade cerebral perfusion: results in short elective arch reconstructive times.逆行和顺行脑灌注：在短时间内选择性弓部重建的结果。
Ann Thorac Surg. 2010 May;89(5):1448-57. doi: 10.1016/j.athoracsur.2010.01.056.
4
Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion during deep hypothermic circulatory arrest in aortic surgery: a meta-analysis of 7023 patients.主动脉手术中深度低温停循环期间顺行性与逆行性脑灌注的相似脑保护效果：对7023例患者的荟萃分析
Artif Organs. 2015 Apr;39(4):300-8. doi: 10.1111/aor.12376. Epub 2015 Mar 4.
5
Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion combined with deep hypothermia circulatory arrest in aortic arch surgery: a meta-analysis and systematic review of 5060 patients.升主动脉逆行灌注与顺行脑灌注联合深低温停循环在主动脉弓手术中脑保护效果相似：5060 例患者的荟萃分析和系统评价。
J Thorac Cardiovasc Surg. 2014 Aug;148(2):544-60. doi: 10.1016/j.jtcvs.2013.10.036. Epub 2013 Dec 9.
6
Deep Hypothermia With Retrograde Cerebral Perfusion Versus Moderate Hypothermia With Antegrade Cerebral Perfusion for Arch Surgery.深低温逆行性脑灌注与中低温顺行性脑灌注在主动脉手术中的应用比较。
Ann Thorac Surg. 2019 Apr;107(4):1104-1110. doi: 10.1016/j.athoracsur.2018.10.008. Epub 2018 Nov 15.
7
Integrated cerebral protection: combined antegrade and retrograde cerebral perfusion during deep hypothermic circulatory arrest.综合脑保护：在深度低温循环停搏期间联合顺行性和逆行性脑灌注。
Innovations (Phila). 2010 Sep;5(5):355-8. doi: 10.1097/IMI.0b013e3181f88dc5.
8
The methodologies of hypothermic circulatory arrest and of antegrade and retrograde cerebral perfusion for aortic arch surgery.用于主动脉弓手术的低温循环停止以及顺行和逆行脑灌注的方法。
Ann Thorac Cardiovasc Surg. 2008 Jun;14(3):138-48.
9
A reappraisal of retrograde cerebral perfusion.逆行性脑灌注的再评价。
Ann Cardiothorac Surg. 2013 May;2(3):316-25. doi: 10.3978/j.issn.2225-319X.2013.01.02.
10
Antegrade or retrograde cerebral perfusion as an adjunct during hypothermic circulatory arrest for aortic arch surgery.在主动脉弓手术的低温循环停搏期间，顺行或逆行脑灌注作为一种辅助手段。
Expert Rev Cardiovasc Ther. 2007 Nov;5(6):1147-61. doi: 10.1586/14779072.5.6.1147.
引用本文的文献
1
Multiple Cardiac Diseases Involving the Aortic Arch: Beating Heart Debranching, and Normothermic Arch Replacement: A Case Series.累及主动脉弓的多种心脏疾病：心脏不停跳下分支血管离断及常温主动脉弓置换术：病例系列
J Clin Med. 2024 Jan 26;13(3):732. doi: 10.3390/jcm13030732.
2
Cerebral Perfusion and Neuromonitoring during Complex Aortic Arch Surgery: A Narrative Review.复杂主动脉弓手术中的脑灌注与神经监测：一项叙述性综述
J Clin Med. 2023 May 15;12(10):3470. doi: 10.3390/jcm12103470.
3
Nitric Oxide in Selective Cerebral Perfusion Could Enhance Neuroprotection During Aortic Arch Surgery.选择性脑灌注中的一氧化氮可增强主动脉弓手术期间的神经保护作用。
Front Cardiovasc Med. 2022 Jan 14;8:772065. doi: 10.3389/fcvm.2021.772065. eCollection 2021.
4
Does Hypothermic Circulatory Arrest for Aortic Surgery Trigger Near-Death Experience? Incidence of Near-Death Experiences after Aortic Surgeries Performed under Hypothermic Circulatory Arrest.主动脉手术中的低温循环停搏会引发濒死体验吗？低温循环停搏下进行主动脉手术后濒死体验的发生率。
Aorta (Stamford). 2021 Apr;9(2):76-82. doi: 10.1055/s-0041-1725091. Epub 2021 Oct 19.
5
Commentary: Protect the brain: An armamentarium of cerebral-protection strategies should be in the aortic surgeon's toolbox.述评：保护大脑：主动脉外科医生的工具箱中应备有一套脑保护策略。
JTCVS Tech. 2020 Apr 3;2:18-19. doi: 10.1016/j.xjtc.2020.03.014. eCollection 2020 Jun.
6
Aortic arch aneurysms and dissection-open repair is the gold standard.主动脉弓动脉瘤和夹层——开放修复是金标准。
Indian J Thorac Cardiovasc Surg. 2019 Jun;35(Suppl 2):136-155. doi: 10.1007/s12055-019-00819-w. Epub 2019 May 22.
本文引用的文献
1
Open Surgical Repair Remains the Gold Standard for Treating Aortic Arch Pathology.开放手术修复仍是治疗主动脉弓病变的金标准。
Ann Thorac Surg. 2017 May;103(5):1413-1420. doi: 10.1016/j.athoracsur.2016.08.064. Epub 2016 Dec 1.
2
Moderate hypothermia at warmer temperatures is safe in elective proximal and total arch surgery: Results in 665 patients.在较高温度下进行中度低温是选择性近端和全弓手术安全的：665 例患者的结果。
J Thorac Cardiovasc Surg. 2017 May;153(5):1011-1018. doi: 10.1016/j.jtcvs.2016.09.044. Epub 2016 Sep 24.
3
Thoracic and cardiovascular surgery in Japan during 2014 : Annual report by The Japanese Association for Thoracic Surgery.2014年日本胸心血管外科：日本胸外科协会年度报告
Gen Thorac Cardiovasc Surg. 2016 Nov;64(11):665-697. doi: 10.1007/s11748-016-0695-3.
4
Implications from neurologic assessment of brain protection for total arch replacement from a randomized trial.一项随机试验中脑保护的神经学评估对全弓置换术的启示
J Thorac Cardiovasc Surg. 2015 Nov;150(5):1140-7.e11. doi: 10.1016/j.jtcvs.2015.07.054. Epub 2015 Jul 26.
5
Long-term outcomes after aortic arch surgery: results of a study involving 623 patients.主动脉弓手术后的长期预后：一项涉及623例患者的研究结果
Eur J Cardiothorac Surg. 2015 Sep;48(3):483-90. doi: 10.1093/ejcts/ezu468. Epub 2014 Dec 2.
6
A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without retrograde cerebral perfusion: analysis based on the Japan Adult Cardiovascular Surgery Database.一项比较顺行性脑灌注与低温循环停搏、或联合逆行性脑灌注在全主动脉弓置换术中脑保护作用的研究：基于日本成人心血管外科学数据库的分析。
J Thorac Cardiovasc Surg. 2015 Feb;149(2 Suppl):S65-73. doi: 10.1016/j.jtcvs.2014.08.070. Epub 2014 Sep 21.
7
Safety and efficacy of retrograde cerebral perfusion as an adjunct for cerebral protection during surgery on the aortic arch.逆行脑灌注作为主动脉弓手术中脑保护辅助手段的安全性和有效性。
J Thorac Cardiovasc Surg. 2014 Dec;148(6):2927-33. doi: 10.1016/j.jtcvs.2014.07.024. Epub 2014 Jul 30.
8
Current trends in cannulation and neuroprotection during surgery of the aortic arch in Europe.欧洲主动脉弓手术期间插管和神经保护的当前趋势。
Eur J Cardiothorac Surg. 2015 May;47(5):917-23. doi: 10.1093/ejcts/ezu284. Epub 2014 Jul 17.
9
New indicator of postoperative delayed awakening after total aortic arch replacement.
Eur J Cardiothorac Surg. 2015 Jan;47(1):101-5. doi: 10.1093/ejcts/ezu141. Epub 2014 Apr 9.
10
Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion combined with deep hypothermia circulatory arrest in aortic arch surgery: a meta-analysis and systematic review of 5060 patients.升主动脉逆行灌注与顺行脑灌注联合深低温停循环在主动脉弓手术中脑保护效果相似：5060 例患者的荟萃分析和系统评价。
J Thorac Cardiovasc Surg. 2014 Aug;148(2):544-60. doi: 10.1016/j.jtcvs.2013.10.036. Epub 2013 Dec 9.
Zotero 插件