Cerebral perfusion issues in type A aortic dissection.
Cerebral perfusion issues in type A aortic dissection.
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DOI：
10.21037/jovs.2018.03.20
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Di Bartolomeo, Roberto
中科院分区：
文献类型：
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作者：
Pacini, Davide;Murana, Giacomo;Di Bartolomeo, Roberto
卒中事件在急性A型主动脉夹层中非常常见。脑灌注不良可能是由于长时间的弓形血管低灌注所引起的，或在弓形修复术中因脑保护不足而在手术后发展。为了减少这一不利的并发症，有几种辅助手段可用于脑保护，如直接顺行或逆行脑灌注(RCP)和使用深至中低温停循环时间，但这些措施往往是不够的，因为术前灌注不良已造成不可逆转的缺血损伤。这篇综述文章的目的是分析A型主动脉夹层中神经损伤的主要系列报道，根据手术处理的类型重点关注结果，并确定可能的预测因素以更好地管理这种并发症。
Stroke events are very common in acute type A aortic dissection. Cerebral malperfusion could manifest at presentation due to prolonged arch vessels hypoperfusion or develop after surgery for inadequate cerebral protection during arch repair. To reduce this detrimental complication there are several adjuncts that can be adopted for cerebral protection such as direct antegrade or retrograde cerebral perfusion (RCP) and use period of deep to moderate hypothermic circulatory arrest time; however, they are often insufficient as preoperative malperfusion already caused irreversible ischemic damages. The aim of the current review article is to analyze the principal series reporting on neurological injuries during type A aortic dissection to focus on the outcomes according to the type of surgical management and identify possible predictors to better manage this complication.