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J Thorac Cardiovasc Surg 2006;132:153-154
© 2006 The American Association for Thoracic Surgery

Brief Communication

Mild hypothermia (32°C) and antegrade cerebral perfusion in aortic arch operations

Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Frankfurt/Main, Germany

^_* Address for reprints: Farhad Bakhtiary, MD, Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590 Frankfurt/M, Germany. (Email: farhad@bakhtiary.de).

The first 20% of the full text of this article appears below.

Antegrade cerebral perfusion (ACP) has been popularized, offering a more physiologic method of perfusion and extending the safe limits for arch repair. ¹ Deep hypothermia has been used as an adjunct to ACP almost universally. The absolute necessity for deep hypothermia once ACP with flow rates and pressures within the physiologic range is provided has been questioned recently. Ehrlich and colleagues ² showed that brain oxygen consumption is reduced by 50% of baseline values if the patient is cooled systemically to 28°C core temperature. Yet the regional cerebral blood flow with antegrade perfusion decreases more rapidly at less than 28°C than between 36°C and 30°C. ³ Thus a perfusate temperature of greater than 28°C should be optimal for ACP to meet the lowered metabolic demands of the brain. By using this modified temperature management, the drawbacks of long cooling and rewarming periods on cardiopulmonary bypass (CPB) could be avoided. This article describes the operative management with this . . . [Full Text of this Article]

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