Clinical Results of Retrograde Cerebral Perfusion in Treatment of Aortic Disease

• Published in: Asian cardiovascular & thoracic annals 1998-12, Vol.6 (4), p.288-294
• Main Authors: Calkavur, Tanzer, Atay, Yuksel, Yagdi, Tahir, Cikirikcoglu, Mustafa, Can, Levent, Gurcun, Ugur, Ozbaran, Mustafa, Bilkay, Onol, Buket, Suat
• Format: Article
• Language: English
• ISSN: 0218-4923; 1816-5370
• DOI: 10.1177/021849239800600412

Between 1993 and 1998, 106 adults underwent ascending aorta or aortic arch operations using deep-hypothermic circulatory arrest and retrograde cerebral perfusion via the superior vena cava. Aortic lesions were acute type I dissection in 44 (41.5%), chronic type I dissection in 12 (11.3%), acute type II dissection in 6 (5.7%), chronic type II dissection in 9 (8.5%), ascending aorta or aortic arch aneurysms in 34 (32.1%), and an aneurysm of the sinus of Valsalva with aortic arch aneurysm in 1 (0.9%). The overall neurologic dysfunction rate was 6.6%. Early mortality was 18.8%. By multivariate analysis, circulatory arrest longer than 60 minutes and chronic renal failure were significant predictors of neurological dysfunction. Female gender, preoperative hemodynamic instability, circulatory arrest longer than 60 minutes, preoperative neurological dysfunction, and preoperative organ malperfusion were significant predictors of early mortality. We concluded that retrograde cerebral perfusion minimized neurological complications by preventing debris and air emboli and by providing adequate metabolic support in patients who needed circulatory arrest for surgical treatment of aortic pathology.