Transpharyngeal Imaging With Transesophageal Echocardiography as an Adjunct for Optimizing Retrograde Cerebral Perfusion

Abstract

NEUROLOGIC PROTECTION DURING aortic arch surgery is challenging. Hypothermic circulatory arrest, retrograde cerebral perfusion, and antegrade cerebral perfusion are a few strategies that have evolved to minimize the neurologic injury that occurs from hypoperfusion. 1 Seco M. Edelman J.J. Van Boxtel B. et al. Neurologic injury and protection in adult cardiac and aortic surgery. J Cardiothorac Vasc Anesth. 2015; 29: 185-195 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar Monitoring adequacy of cerebral perfusion is of paramount importance despite the strategy that is adopted. Retrograde cerebral perfusion is an established technique in patients undergoing aortic arch surgery with atheromatous cervical branches. 2 Ueda Y. A reappraisal of retrograde cerebral perfusion. Ann Cardiothorac Surg. 2013; 2: 316-325 PubMed Google Scholar This case report highlights the clinical adoption of transpharyngeal ultrasonography as a surrogate marker for assessing adequacy of retrograde cerebral perfusion in a patient who underwent successful surgery for acute type-A aortic dissection. Approval of this study was obtained from the Institutional Medical Ethics and Scientific Research Committee (MESRC number 73/2016), and written consent to publish data was obtained from the patient.