Abstract
Ten patients underwent aortic arch replacement for aneurysmal disease using cardiopulmonary bypass (CPB) with conventional selective cerebral perfusion (Group I, 4 patients) or partial brachiocephalic perfusion (Group II, 6 patients). All group I patients underwent elective surgery and 5 of 6 patients (Group II) had urgent operation for ruptured aneurysm. The partial brachiocephalic perfusion was accomplished by perfusion to the right axillar artery using separate pump (flow 300-500 ml/min, pressure 40-60 mmHg) under the low CPB flow, deep systemic cooling (21.7±1.5°C) and retrograde cardioplegia. Each group had one death caused by hemorrhage. Among the survivors, there were one post operative stroke on each group. However, one is reattack and other caused intraoperative air emboli. On the basis of these results, simplified technique of brachiocephalic perfusion provides attractive and safe alternative.
