Antegrade Brain Perfusion for Pulmonary Thromboendarterectomy英文文献资料.docVIP

World Journal of Cardiovascular Surgery, 2011, 1, 24-28 doi:10.4236/wjcs.2011.12005 Published Online December 2011 (http://www.SciRP.org/journal/wjcs) Antegrade Brain Perfusion for Pulmonary Thromboendarterectomy Jean Francois Morin, Andrew Hirsch, Senthuran Tharmalingam Jewish General Hospital Division of Respiratory Medicine, McGill University, Montreal, Canada E-mail: {jmorin, ahirsch}@jgh.mcgill.ca, senthuran_t@ Received September 28, 2011; revised October 30, 2011; accepted November 11, 2011 Abstract Objective: The gold standard procedure for pulmonary thromboendarterectomy is median sternotomy, car- diopulmonary bypass, profound hypothermia (18?C) and circulatory arrest. We propose a modified technique to improve the quality of care in this patient population, based on an intervention previously used in aortic surgery. Method: In our modified technique, we cannulated the right axillary artery to allow antegrade brain perfusion while on circulatory arrest. In this retrospective study, we have reviewed the data relating to the first 7 patients on whom we performed the modified technique and have made comparison with a group of 7 case-matched individuals who underwent the standard technique (control group). Results: The modified technique allowed for use of moderate hypothermia (25 ?C - 28?C). Patients in both groups woke up without neurologic complications. A trend towards, but non-significant reduction in duration of surgery from 303 (±42) to 279 (±44), duration of postoperative inotropic support from 2.7 ± 3.4 days to 1.7 ± 2.0 days, as well as postoperative mechanical ventilation time from 4.87 (±3.7) to 2 (±2.7) days were seen in the control and modified groups respectively. All patients in the modified group woke up on post-operative day 0, whereas most patients in the control group awoke on postoperative day 1. No significant differences were noted in the reduction in preoperative to postoperative systolic pulmonary artery pressur