Abstract
The surgical management of aneurysms involving the aortic arch has been fraught with technical difficulties in the past. In only a few reports (1 – 3) has the surgical outcome in a sufficiently large number of patients with an aortic arch aneurysm been described. It is no exaggeration to say that the success of an operation for the repair of an aortic arch aneurysm mainly depends on how well the brain is protected from ischemia during aortic arch repair. For reconstruction of the aortic arch or adjacent part of the aorta, the following methods have been used as supportive techniques: hypothermic cardiopulmonary bypass (CPB) with selective cerebral perfusion (SCP) (4 – 6), hypothermic CPB with circulatory arrest (7 – 10) and hypothermic CPB with retrograde cerebral perfusion (11). From April 1989, based on results from our experimental studies (12), we have employed hypothermic CPB with SCP as the supportive method for the surgical treatment of aortic arch aneurysms. This report describes the SCP technique and results in 74 patients and includes discussion about its advantages.
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