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Hybrid Technique to Correct Cerebral Malperfusion Following Repair of a Type A Aortic Dissection

  • Kim, Seon Hee (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Song, Seunghwan (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Kim, Sang-Pil (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Lee, Jonggeun (Department of Thoracic and Cardiovascular Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Lee, Han Cheol (Division of Cardiology, Departments of Internal Medicine, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Kim, Eun Soo (Department of Anesthesiology and Pain Medicine, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine)
  • Received : 2013.08.05
  • Accepted : 2013.10.11
  • Published : 2014.04.05

Abstract

A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation ($rSO_2$) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right $rSO_2$ did not recover. Angiography revealed another intimal tear on the right common carotid artery. A stent was then inserted. The right $rSO_2$ promptly increased to the same level as that of the left one. The patient was discharged without any neurologic complications.

Keywords

References

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  1. Cerebral malperfusion in acute aortic dissection vol.46, pp.12, 2016, https://doi.org/10.1007/s00595-016-1381-x
  2. Open brachiocephalic artery stent for static obstruction caused by acute type A aortic dissection vol.2019, pp.2, 2014, https://doi.org/10.1093/jscr/rjz018
  3. Application of hybrid operating rooms for clipping large or giant intracranial carotid-ophthalmic aneurysms vol.8, pp.21, 2014, https://doi.org/10.12998/wjcc.v8.i21.5149