Brain protection in perioperative period of aortic arch surgery

Abstract

Maintaining optimal cerebral perfusion during cardiopulmonary bypass and circulatory arrest is basis of intraoperative management of aortic arch surgery. Various cerebral protection techniques including hypothermia, cerebral perfusion, drug protection and blood gas management have been used in the clinic, but the optimal strategy remains difficult to determine. The clinical outcome of cerebral protection in aortic arch surgery largely depends on brain temperature, circulatory arrest time and cerebral perfusion at the time of circulatory arrest. The optimal brain protection strategy should be individualized treatment on the basis of comprehensive brain monitoring, so as to effectively reduce the occurrence of brain injury. This article summarizes the means or indicators of brain monitoring and management during cardiopulmonary bypass in aortic arch surgery, as well as perioperative brain protection strategies, in order to guide the clinical practice of intraoperative brain protection in aortic arch surgery.

Keywords

• aorta, thoracic
• extracorporeal circulation
• cardiovascular surgical procedures
• perioperative period
• review