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Eur J Cardiothorac Surg 2007;32:268-269. doi:10.1016/j.ejcts.2007.04.015
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Editorial comment

Normothermic selective cerebral perfusion — how safe is it?

First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Hamamatsu 431-3192, Japan

^_* Corresponding author. Tel.: +81 53 435 2276; fax: +81 53 435 2272. (Email: tkazui@hama-med.ac.jp).

The first 20% of the full text of this article appears below.

I read the article by Touati and colleagues with great interest [1]. In this study, the authors analyze the surgical outcome of 29 patients who underwent total aortic arch replacement under normothermic conditions without circulatory arrest. There was one in-hospital death (3.4%). Transient neurological deficit was apparently seen in one patient. The authors compare their technique and results with those of arch replacements under profound hypothermic circulatory arrest and propose that their strategy ensures a more physiological autoregulation of cerebral blood flow and maintains body perfusion without high vascular resistance. Before we go on to discuss this work, I think it is important to remember that the authors are reporting on their experiences with the above technique in a very small series of patients – a fact that almost automatically precludes any definitive conclusions to be drawn from here.

Antegrade selective cerebral perfusion (SCP) has now established itself as the most reliable method of brain protection during aortic arch repair operations. While the technique is basically performed under profound or at least moderate hypothermic . . . [Full Text of this Article]