Anesthetic Management during Aortic Arch Surgery Using Anterograde Selective Cerebral Perfusion.

Han,  Sung Hee; Ham,  Byung Moon; Oh,  Young Seok; Kim,  Wook Sung; Park,  Yun Ock; Lee,  Gyu Ho

doi:2003.45.6.784

Case Report

Korean Journal of Anesthesiology 2003;45(6):784-788.
DOI: https://doi.org/10.4097/kjae.2003.45.6.784

Anesthetic Management during Aortic Arch Surgery Using Anterograde Selective Cerebral Perfusion.

Sung Hee Han, Byung Moon Ham, Young Seok Oh, Wook Sung Kim, Yun Ock Park, Gyu Ho Lee

¹Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
²Department of Thoracic Surgery, College of Medicine, Inje University, Korea.
³Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Seoul, Korea. noninvasive@hanmail.net

Abstract

Cerebral protection during aortic arch surgery is an anesthetic challenge, since the surgical procedures for aortic arch aneurysm involve an interruption of cerebral blood flow. We report a successfully managed case of aortic arch aneurysm repair with antegrade selective cerebral perfusion (SCP) during TCA (total circulatory arrest) using a transcranial oximeter, cerebral oxygenation was monitored during surgery. Although at the beginning of TCA a decrease in the regional cerebral oxygen saturation was observed, this was soon recovered by SCP. Except for the short period of TCA without SCP, regional cerebral oxygen saturation (rSO2) value were well maintained during surgery.

Key Words: cerebral protection; regional cerebral oxygen saturation (rSO2); selective antegrade cerebral perfusion (SCP); transcranial oximeter; total circulatory arrest (TCA)