Di Bartolomeo Roberto, Murana Giacomo, Fiorentino Mariafrancesca, Di Marco Luca, Pacini Davide
Alma mater professor, University of Bologna, Bologna, Italy.
Division of Cardiac Surgery, Cardiac Surgery Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138, Bologna, Italy.
Indian J Thorac Cardiovasc Surg. 2022 Apr;38(Suppl 1):44-49. doi: 10.1007/s12055-022-01347-w. Epub 2022 Mar 28.
Complications after open arch repair much decreased over time thanks to better methods of organ and cerebral protection. The crossroads was the introduction of antegrade cerebral perfusion as a method of cerebral protection. Other intraoperative techniques also contributed to facilitate arch reconstruction, such as performing circulatory arrest at higher core temperature, using hybrid grafts or endografts, and monitoring cerebral functions during the procedure. As part of this exciting process, we go back in Bologna in the early 1970s to relive some of these fundamental steps on aortic arch surgery. Today a large number of issues on cerebral protection remain for which we have incomplete responses. Probably, a super specialized approach and endovascular techniques will continue to improve the quality of care of patients with different arch pathologies.
由于采用了更好的器官和脑保护方法，开放主动脉弓修复术后的并发症随着时间的推移大幅减少。转折点是引入顺行性脑灌注作为一种脑保护方法。其他术中技术也有助于促进主动脉弓重建，例如在较高核心体温下进行循环阻断、使用杂交移植物或腔内移植物，以及在手术过程中监测脑功能。作为这一激动人心进程的一部分，我们回到20世纪70年代初的博洛尼亚，重温主动脉弓手术的一些基本步骤。如今，关于脑保护仍有大量问题，我们的回答并不完整。或许，一种超级专业化的方法和血管内技术将继续提高不同主动脉弓病变患者的护理质量。
