Perfusion Pressure Does Not Affect Neurologic Outcome in Axillary Artery Side Graft Cannulation in Type A Aortic Dissection
Objective. Antegrade selective cerebral perfusion (ASCP) through the right axillary is a safe and effective method for cerebral protection in aortic surgery. In the present study, we evaluated whether or not pressure control in ASCP affected the neurologic outcome.
Method. Sixty-two patients (17 female, 45 male) with a mean age of 53.9 ± 9.4 years (range, 23-74 years) with a diagnosis of Type A aortic dissection were operated on by using the right axillary artery side graft cannulation technique. ASCP with pressure control was used in the first 37 (59.6%) patients (group 1), whereas ASCP with flow control was used in the consecutive 25 patients (39.4%) (group 2). The groups were compared according to postoperative neurologic outcomes.
Results. The hospital mortality rate was 9.7% with 6 patients. The mean ASCP flows of group 1 was 663 ± 76 mL/min and 692 ± 51 mL/min in group 2. This difference was not statistically significant (P = .120). The neurological dysfunction rates were 2.7% in group 1 with 1 patient and 8% in group 2 with 2 patients (P = .560).
Conclusion. In this study, we could not find a statistically significant difference in patients treated with ASCP through the right axillary applicated with pressure control versus flow control.
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