A novel technique of cerebral-body separate perfursion combine with mild hypothermia during acute stanford a aortic dissectionitle

P0018 

Abstract Submission 

kexiang liu (1), weitie wang (2)

(1) N/A, Jilin, Jilin, (2) Department of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, CA

Kexiang Liu    -  Contact Me
N/A

weitie wang    -  Contact Me
Department of Cardiovascular Surgery, The Second Hospital of Jilin University

Kexiang Liu    -  Contact Me
N/A

This retrospective study was conducted by collecting data from 176 consecutive patients (105 men, mean age 52.54±12.38 years) with TAAD from October 2019 to December 2020. Cerebral and body perfusion were provided by the same pump of CPB. The right axillary artery, femoral artery, superior and inferior vena cava were disassociated for cannulation. The right axillary artery and the left common carotid artery were used for antegrade-selective cerebral perfusion. Once the balloon was deployed into the stent graft, perfusion of the lower body was resumed through the femoral artery. Antegrade-selective cerebral perfusion and lower body perfusion were provided by the same pump. The CPB flow was gradually returned to 1.6-1.9 L.min-1.
Oxygen saturation of superior and inferior vena cava was monitor and used for regulating the perfusion flow during cerebral-body separate. In brief, detect the superior vena cava oxygen saturation before CPB, 5 minutes during CPB, 10, 20 and 30 minutes during cerebral-body separate perfursion. Increase the perfusion flow if superior vena cava oxygen saturation lower than 65% or 10% of the oxygen saturation before CPB.
The operation was performed by the same surgeon in all patients. All the operations were successfully completed with no intra-operative death. The mean hypothermic circulatory arrest time was 5.79±0.6 minutes, cerebral perfusion flow was 800-1000 L.min-1, cerebral-body separate perfursion time was 40.07±8.78 min,
aortic cross-clamp time was 110.8±21.7, cardiopulmonary
bypass time was 141.8±19.3 min. Rectal
temperature at circulatory arrest
was 34.43±0.75℃.Minimum temperature at
circulatory arrest was 32.33±0.76 ℃.
There was 11 death in hospital. Consciousness recovery time was 4.85±1.97 h. Mechanical ventilation time was 23.8±24.46 h. There are 19 patients need CRRT. Neurological events especially transient consciousness disorder occurred in 4 patients, permanent consciousness disorder occurred in 2 patients. There were no early events, such as paraplegia, cerebral infarction, and limb ischemia. (Table 3)
Oxygen saturation of superior vena cava at 10, 20, 30, 40 minutes during cerebral-body separate was 70.95%, 71.30%, 72.03% and 72.9%. Inferior vena oxygen saturation was 63.95%, 62.94%, 63.92% and 69.1%. The perfusion flow was 1.73, 1.83, 1.82, 1.79 L.min-1.

Aortic Arch