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Nygammal metod minskar neurologisk risk vid arcus aortae-kirurgi. Selektiv antegrad hjärnperfusion ger bra skydd, visar retrospektiv studie

Landenhed Smith, Maya LU ; Ingemansson, Richard LU and Koul, Bansi LU (2010) In Läkartidningen 107(16). p.1058-1061
Abstract
nnominate artery and left carotid artery cannulation for antegrade brain perfusion allows accurate bilateral pressure-controlled brain perfusion. The aim of this study was to evaluate the incidence of adverse neurological events and 90-day mortality in 40 consecutive patients undergoing elective aortic arch repair using this technique. Forty consecutive patients underwent elective aortic arch repair using selective antegrade brain perfusion. The perfusion was instituted by cannulation of the innominate artery (using standard cannulae) and by direct cannulation of the left common carotid artery (using cannulae having a built-in-side arm for pressure monitoring). Bilateral radial artery and left common carotid artery pressure monitoring... (More)
nnominate artery and left carotid artery cannulation for antegrade brain perfusion allows accurate bilateral pressure-controlled brain perfusion. The aim of this study was to evaluate the incidence of adverse neurological events and 90-day mortality in 40 consecutive patients undergoing elective aortic arch repair using this technique. Forty consecutive patients underwent elective aortic arch repair using selective antegrade brain perfusion. The perfusion was instituted by cannulation of the innominate artery (using standard cannulae) and by direct cannulation of the left common carotid artery (using cannulae having a built-in-side arm for pressure monitoring). Bilateral radial artery and left common carotid artery pressure monitoring allowed precise, pressure-controlled bilateral brain perfusion. Bilateral selective antegrade brain perfusion was given with a perfusion rate of 4.6 ml to 15.9 ml/kg/min (mean 9.6 ml/kg/min). This was sufficient to obtain dual-controlled mean cerebral perfusion pressures of 50-70 mmHg as monitored simultaneously in the right radial artery and the left carotid artery. The incidence of stroke and transient neurological dysfunction was 2.5 % each. Ninety-day mortality was 2.5 %. Pressure-controlled, bilateral, selective antegrade brain perfusion by innominate artery cannulation seems to be a safe method for cerebral protection during elective aortic arch repair. (Less)
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organization
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type
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published
subject
keywords
Aortic Valve Insufficiency: surgery, Brachiocephalic Trunk: physiology, Carotid Artery, Common: physiology, Catheterization: methods, Cerebrovascular Circulation: physiology, Heart Arrest, Induced: adverse effects, Perfusion: methods, Stroke: etiology, Vascular Surgical Procedures: adverse effects, Stroke: prevention & control, Thoracic: surgery, Aorta, Aortic Aneurysm: surgery, Vascular Surgical Procedures: methods, Vascular Surgical Procedures: mortality
in
Läkartidningen
volume
107
issue
16
pages
1058 - 1061
publisher
Sveriges Läkarförbund
external identifiers
  • PMID:20476700
ISSN
0023-7205
language
Swedish
LU publication?
yes
id
71caabe9-845a-40c7-b6fc-1da0c64dcbc5 (old id 1610164)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20476700?dopt=Abstract
http://ltarkiv.lakartidningen.se/artNo37994
date added to LUP
2010-06-02 10:56:57
date last changed
2016-04-16 06:48:21
@misc{71caabe9-845a-40c7-b6fc-1da0c64dcbc5,
  abstract     = {nnominate artery and left carotid artery cannulation for antegrade brain perfusion allows accurate bilateral pressure-controlled brain perfusion. The aim of this study was to evaluate the incidence of adverse neurological events and 90-day mortality in 40 consecutive patients undergoing elective aortic arch repair using this technique. Forty consecutive patients underwent elective aortic arch repair using selective antegrade brain perfusion. The perfusion was instituted by cannulation of the innominate artery (using standard cannulae) and by direct cannulation of the left common carotid artery (using cannulae having a built-in-side arm for pressure monitoring). Bilateral radial artery and left common carotid artery pressure monitoring allowed precise, pressure-controlled bilateral brain perfusion. Bilateral selective antegrade brain perfusion was given with a perfusion rate of 4.6 ml to 15.9 ml/kg/min (mean 9.6 ml/kg/min). This was sufficient to obtain dual-controlled mean cerebral perfusion pressures of 50-70 mmHg as monitored simultaneously in the right radial artery and the left carotid artery. The incidence of stroke and transient neurological dysfunction was 2.5 % each. Ninety-day mortality was 2.5 %. Pressure-controlled, bilateral, selective antegrade brain perfusion by innominate artery cannulation seems to be a safe method for cerebral protection during elective aortic arch repair.},
  author       = {Landenhed Smith, Maya and Ingemansson, Richard and Koul, Bansi},
  issn         = {0023-7205},
  keyword      = {Aortic Valve Insufficiency: surgery,Brachiocephalic Trunk: physiology,Carotid Artery,Common: physiology,Catheterization: methods,Cerebrovascular Circulation: physiology,Heart Arrest,Induced: adverse effects,Perfusion: methods,Stroke: etiology,Vascular Surgical Procedures: adverse effects,Stroke: prevention & control,Thoracic: surgery,Aorta,Aortic Aneurysm: surgery,Vascular Surgical Procedures: methods,Vascular Surgical Procedures: mortality},
  language     = {swe},
  number       = {16},
  pages        = {1058--1061},
  publisher    = {ARRAY(0x839f130)},
  series       = {Läkartidningen},
  title        = {Nygammal metod minskar neurologisk risk vid arcus aortae-kirurgi. Selektiv antegrad hjärnperfusion ger bra skydd, visar retrospektiv studie},
  volume       = {107},
  year         = {2010},
}