The Clinical Study On Cerebral Complication And Brain Protection For Aortic Aneurysm Surgery With Deep Hypothermic Circulatory Arrest

Objective:We retrospectively analyzed neurological outcome after operations on the aortic arch with deep hypothermic circulatory arrest (DHCA) in combination with antegrade selective cerebral perfusion (ASCP) to determine predictive risk factors of cerebral complications.Methods:Retrospectively collected data were analyzed on 79 patients(male 68 cases, female 11 cases, mean age 46(?)14 years) operations on the aortic arch with DHCA in combination with unilateral ASCP (66 patients) and bilateral ASCP (13 patients) underwent between August 2003 and July 2004. Indications for surgical intervention were Stanford A aortic dissection in 72 (91.1%) patients, degenerative aneurysm in 5 (6.3%) patients, false aneurysm in 2 (2.5%) patients. Thirty-nine (50%) patients were operated on urgently; concomitant procedures were performed in 23 (29.1%) patients. For each patient, antegrade selective cerebral perfusion (flow rate, 10ml/kg/min) was used at a nasal temperature of 18℃. Mean cerebral perfusion time was 26714 minutes (range 6-90 minutes). Cerebral complications occurred in 22 (28.2%) patients, including 15 (19.2%) patients with temporary neurological dysfunction (TND) and 5 (6.4%) patients with permanent neurological dysfunction (PND), 2 (2.6%) patients with severe global cerebral dysfunction. Perioperative factors were evaluated by means of univariate and multivariate logistic analysis to identify relative risk factors of cerebral complications.Results:...