[主动脉弓置换术中的脑保护——经右腋动脉进行深低温选择性脑灌注]

[Brain protection on the aortic arch replacement--with deep hypothermic selective cerebral perfusion via right axillary artery].

作者信息

Noguchi Y, Naito Y, Fujiwara K, Takagaki Y, Goto Y, Okamoto M, Hirooka N, Nishioka T, Kawasaki S, Tojo S

机构信息

Department of Thoracic and Cardiovascular Surgery, Wakayama Medical College, Japan.

出版信息

Kyobu Geka. 1993 Jul;46(8 Suppl):644-7.

PMID:8371522

Abstract

Graft replacement was performed in the treatment of 31 patients with aneurysm involving the aortic arch from May, 1986 to December, 1992. Of the 31 patients, 16 had true aneurysm, 13 had aortic dissection and 2 had Annuloaortic ectasia. From May 1986 to May 1989, we did not have the policy about brain protection. Since June 1989, we performed the aortic arch surgery with deep hypothermic selective cerebral perfusion via right axillary artery and used open distal anastomosis technique. Besides, we exchanged the perfusion site to the ascending aorta when we finished the selective cerebral perfusion. In that way, brain complication rate was decreased from 57.1% to 11.7% and operative mortality was decreased from 85.7% to 29.1%.

摘要

1986年5月至1992年12月期间，对31例累及主动脉弓的动脉瘤患者进行了移植物置换术。31例患者中，16例为真性动脉瘤，13例为主动脉夹层，2例为主动脉环扩张。1986年5月至1989年5月，我们没有脑保护策略。自1989年6月起，我们采用经右腋动脉深低温选择性脑灌注进行主动脉弓手术，并采用开放远端吻合技术。此外，在完成选择性脑灌注后，我们将灌注部位改为升主动脉。通过这种方式，脑并发症发生率从57.1%降至11.7%，手术死亡率从85.7%降至29.1%。