Aortic arch surgery using bilateral antegrade selective cerebral perfusion in combination with near-infrared spectroscopy
Aortic arch surgery using bilateral antegrade selective cerebral perfusion in combination with near-infrared spectroscopy
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DOI：
10.1016/j.ejcts.2010.03.016
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发表时间：
2010-11-01
影响因子：
3.4
通讯作者：
Grabenwoeger, Martin
中科院分区：
文献类型：
--
作者：
Harrer, Marieluise;Waldenberger, Ferdinand Rudolf;Grabenwoeger, Martin
目的 近红外光谱 (NIRS) 补充主动脉弓手术期间脑氧合的在线监测 其添加目标是提高采用双侧顺行脑灌注 (BACP) 和微温血液条件下停循环的复杂手术的安全性 我们报告使用 BACP 和中度低温停循环 (MHCA) 的 NIRS 引导主动脉弓手术的结果 方法 2006 年 12 月至 2008 年 12 月期间，NIRS 在 13 名患者中使用（平均年龄 67 5 +/- 11 3 岁）接受 BACP 联合 MHCA 进行主动脉弓修复 八名患者诊断为动脉粥样硬化性胸动脉瘤，五名患者诊断为急性主动脉夹层 七名患者进行了半弓置换术，六名患者接受了冷冻支架移植弓置换术，四名患者进行了冠状动脉旁路移植术 (CABG) 或主动脉瓣手术等伴随手术 我们采用适应灌注方式的算法的方案包括局部脑氧饱和度下降的阈值
Objective Near infrared spectroscopy (NIRS) complements online monitoring of cerebral oxygenation during aortic arch surgery Its addition targets at an increase of safety of a complex procedure employing bilateral antegrade cerebral perfusion (BACP) and circulatory arrest under tepid blood temperatures We report the outcome of NIRS guided aortic arch surgery using BACP with moderate hypothermic circulatory arrest (MHCA) Methods Between December 2006 and December 2008, NIRS was used in 13 patients (mean age 67 5 +/- 11 3 years) undergoing aortic arch repair using BACP combined with MHCA The diagnosis was atherosclerotic thoracic aneurysms in eight and acute aortic dissection in five patients Seven patients had a hemi arch replacement, six underwent frozen stent graft arch replacement and four patients had concomitant procedures such as coronary artery bypass grafting (CABG) or aortic valve surgery Our regimen of employing an algorithm for adaptation of perfusion modalities included the threshold of the drop in regional cerebral oxygen saturation