Usefulness of antegrade selective cerebral perfusion during aortic arch operations

Selective Cerebral Perfusion with the Open Proximal Technique during Descending Thoracic or Thoracoabdominal Aortic Repair: An Option of Choice to Reduce Neurologic Complications

“…Previous studies have identified risk factors for TND as being preoperative cerebrovascular disease, patient age, undergoing an emergent operation, and a long duration of CA. 4,[15][16][17][18] The present study showed that limiting the duration of cerebral ischemia could reduce the incidence of neurologic complications. The use of SCP for DTA or TAA surgery, resulting in a shorter period of cerebral ischemia, may reduce the risk of TND.…”

Anterolateral Thoracotomy for Distal Aortic Arch Disease

“…To flush debris or air from the arch and arch vessels, an antegrade flow through the axillary cannula is effective; however, selective cerebral perfusion through a median sternotomy remains the gold standard in preventing cerebral embolism in most cases. 7 In contrast, Kato et al reported the effectiveness of a combined procedure including a median sternotomy and the implantation of a selfexpanding stent graft in the distal anastomotic portion. 8 For high-risk patients with a severely atherosclerotic arch, so-called open stenting might be feasible to avoid a thoracotomy.…”

Total arch replacement using a stepwise distal anastomosis for arch aneurysms with distal extension☆

“…The most common approach for arch to distal arch aneurysms is currently through median sternotomy [1][2][3][4]. This approach aims to provide cerebral and cardiac safety.…”

“…For arch to distal arch aneurysms, it is not agreed whether a median or lateral approach is better, particularly for aneurysms with distal extension [1][2][3][4][5][6][7]. The median approach aims to provide cerebral and cardiac safety [1][2][3][4].…”

“…The median approach aims to provide cerebral and cardiac safety [1][2][3][4]. However, the distal anastomosis is often difficult and bleeding from it is a serious problem [6,7].…”