Surgical Treatment of Acute Aortic Dissection and Retrograde Cerebral Perfusion

Three patients underwent resection and graft replacement of ascending aorta and aortic arch for acute Type I dissection. Retrograde cerebral perfusion through the superior vena cava cannula was used as an adjunct to deep hypothermic total circulatory arrest. The underlying idea was to protect cerebral tissue and to prevent air and particulate embolism. On the first postoperative day, all three patients were found awake and conscious. Oxygen saturation and blood glucose determinations in blood perfused through the superior vena cava and in venous blood returning from the carotid orifices indicated that cerebral metabolic activity persisted even during deep hypothermic total circulatory arrest. Oxygen saturations and blood glucose levels were found lower in the blood, returning from the carotid orifices than the blood perfused through the superior vena cava. This technique seems as an easy procedure to apply and provides advantages during surgical treatment of aortic dissection and aortic arch surgery.