Surgery of the thoracic aorta using selective antegrade cerebral perfusion: A 3-years experience

Brain protection is a primary concern in thoracic aorta surgery. Which is the best technique to prevent ischemic cerebral injury is still controversial. Between November 1996 and November 1999, 80 consecutive patients were operated on in our institute on the thoracic aorta using Antegrade Selective Cerebral Perfusion (SCP) with moderately hypothermic circulatory arrest (22 degrees-25 degrees C), The mean CardioPulmonary Bypass (CPB) time was 175.2+/-54.5 minutes, the mean aortic cross-clamp time was 106.5+/-38 minutes, the mean SCP time was 50+/-27 minutes (range 18-140 min). Early death (30-day) occurred in 7 patients (8.7%). Early neurological morbidity included stroke in 1 patient (1.3%), and transient neurological deficits in 6 patients (7.5%). In our experience the technique of moderately hypothermic CPB with SCP during surgery of the thoracic aorta provides encouraging results with regard to cerebral function preservation.