Near-Infrared Spectroscopy-Detected Cerebral Ischemia Resolved by Cannulation of an Axillo-Femoral Graft during Surgical Repair of Type A Aortic Dissection
DOI:
https://doi.org/10.1532/HSF98.20121027Abstract
We report the case of a patient who experienced near-infrared spectroscopy (NIRS)-detected transient regional cerebral desaturation during cardiopulmonary bypass for an operation to replace the aortic arch. Prompt institution of additional flow through an axillo-femoral graft was associated with restoration of regional cerebral saturation. The aortic surgery had no neurologic complications. Promptness in detecting and restoring cerebral perfusion appeared crucial in avoiding prolonged cerebral ischemia and reducing the likelihood of adverse neurologic events.References
Hagan PG, Nienaber CA, Isselbacher EM, et al. 2000. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA 283:897-903.nMurkin JM, Arango M. 2009. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth 103(Suppl 1):i3-13.nOlsson C, Thelin S. 2006. Regional cerebral saturation monitoring with near-infrared spectroscopy during selective antegrade cerebral perfusion: diagnostic performance and relationship to postoperative stroke. J Thorac Cardiovasc Surg 131:371-9.nOrihashi K, Sueda T, Okada K, Imai K. 2006. Detection and monitoring of complications associated with femoral or axillary arterial cannulation for surgical repair of aortic dissection. J Cardiothorac Vasc Anesth 20:20-5.nStrauc JT, Spielvogel T, Lauten A, et al. 2004. Axillary artery cannulation: routine use in ascending aorta and aortic arch replacement. Ann Thorac Surg 78:103-8.n
