Le Mee F, Roques X, Laborde N, Guibaud J P, Baudet E
Service de chirurgie cardiovasculaire, hôpital Cardiologique de Haut-Levêque, Pessac.
Arch Mal Coeur Vaiss. 1995 Nov;88(11):1601-7.
The aim of this study was to evaluate the technique of cerebral protection by selective cerebral perfusion with moderate hypothermia during surgery of the transverse aortic arch. Twenty-three patients were operated for partial or total replacement of the transverse aortic arch between January 1987 and December 1993 by the technique of selective cerebral perfusion by bilateral carotid cannulation. There were 12 cases of aneurysm of the ascending aorta and/or transverse aortic arch, one aneurysm of the innominate artery and 10 Stanford type A aortic dissections. The selective cerebral flow rate was 1-1.5 l/min; the perfusion pressure 60-80 mmHg and the temperature of cerebral perfusion 25-28 degrees C. The perioperative mortality was 13%; the causes of death were not neurological (3 haemorrhages). The neurological morbidity was 10% (one brachial monoparesis and one bulbar tetraparesis). This is therefore a useful technique of cerebral protection which avoids the complications of deep hypothermia with circulatory arrest and does not limit the time of aortic repair.
本研究的目的是评估在横断主动脉弓手术期间采用选择性脑灌注联合中度低温进行脑保护的技术。1987年1月至1993年12月期间，23例患者接受了双侧颈动脉插管选择性脑灌注技术下的部分或全横断主动脉弓置换手术。其中有12例升主动脉和/或横断主动脉弓动脉瘤、1例无名动脉瘤和10例斯坦福A型主动脉夹层。选择性脑血流速度为1 - 1.5升/分钟；灌注压力为60 - 80毫米汞柱，脑灌注温度为25 - 28摄氏度。围手术期死亡率为13%；死亡原因并非神经系统方面的（3例出血）。神经功能障碍发生率为10%（1例臂部单瘫和1例延髓性四肢瘫）。因此，这是一种有用的脑保护技术，可避免深低温停循环的并发症，且不限制主动脉修复时间。
