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Cardiol Clin. 2017 Aug;35(3):453-465. doi: 10.1016/j.ccl.2017.03.011. Epub 2017 May 26.

Neuroprotection Strategies in Aortic Surgery.

Author information

1
Thoracic Aortic Surgery Program, Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, C-310, Aurora, CO 80045, USA.
2
Perfusion Services, University of Colorado Hospital, 12605 East 16th Avenue, Mail Stop B200, Aurora, CO 80045, USA.
3
Perfusion Services, Perioperative Services, University of Colorado Hospital, 12605 East 16th Avenue, Mail Stop B200, Aurora, CO 80045, USA.
4
Thoracic Aortic Surgery Program, Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, C-310, Aurora, CO 80045, USA. Electronic address: Brett.Reece@ucdenver.edu.

Abstract

Neurologic injury is a potentially devastating complication of aortic surgery. The methods used in aortic surgery, including systemic cooling, initiation of circulatory arrest, and rewarming during the replacement of the aortic arch, are the most complex circulatory management and surgical procedures performed in modern-day surgery. Despite the plethora of published literature, neuroprotection in aortic surgery is largely based on observational studies and institutional-based practices. This article summarizes the current evidence and emerging strategies for neuroprotection in aortic arch operations.

KEYWORDS:

Antegrade cerebral perfusion; Brain oximetry; Circulatory arrest; Deep hypothermic circulatory arrest; Near-infrared spectroscopy; Neurologic monitoring; Neuroprotection; Retrograde cerebral perfusion

PMID:
28683913
DOI:
10.1016/j.ccl.2017.03.011
[Indexed for MEDLINE]

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