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Indian Journal of Thoracic and Cardiovascular Surgery

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18-10-2023 | Circulatory Arrest | Review Article

Cerebral protection strategies for type A aortic dissection repair

Authors: Faisal A. Shaikh, Sarah I. Khalil, Erik H. Ander, Hannah R. Calvelli, Mohammed A. Kashem, Suyog A. Mokashi

Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Special Issue 2/2023

Abstract

Importance

Techniques to preserve neurological function during type A aortic dissection repairs have been broadly discussed in the literature and heavily debated. Despite the effectiveness of various approaches, a consensus lacks on how to maintain optimal cerebral temperature during surgery. This review examines the three predominant cerebral protection strategies in aortic arch reconstructions: straight deep hypothermic circulatory arrest (sDHCA), retrograde cerebral perfusion (RCP), and antegrade cerebral perfusion (ACP).

Observations

The signature characteristics of sDHCA, RCP, and ACP are similar—hypothermia, with or without cerebral perfusion. Employing cerebral perfusion techniques may prolong operative times, while ACP permits operation at higher body temperatures, albeit with restricted operative durations.

Conclusion

For type A dissection arch reconstructions, sDHCA, RCP, and ACP can be successfully implemented. Factors such as operative times and individual patient conditions should be considered when choosing a cerebral protection strategy.

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Title: Cerebral protection strategies for type A aortic dissection repair
Authors: Faisal A. Shaikh
Sarah I. Khalil
Erik H. Ander
Hannah R. Calvelli
Mohammed A. Kashem
Suyog A. Mokashi
Publication date: 18-10-2023
Publisher: Springer Nature Singapore
Keywords: Circulatory Arrest
Aortic Dissection
Published in: Indian Journal of Thoracic and Cardiovascular Surgery / Issue Special Issue 2/2023
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI: https://doi.org/10.1007/s12055-023-01605-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cerebral protection strategies for type A aortic dissection repair

Abstract

Importance

Observations

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Importance

Observations

Conclusion

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