Visceral protection during moderately hypothermic selective antegrade cerebral perfusion through right brachial artery.

Objective: This study investigates distal organ protection during moderately hypothermic right brachial artery selective antegrade cerebral perfusion (MHSACP) in patients undergoing aortic arch repair.

Methods: Fifty patients undergoing ascending aorta/aortic arch repair using the MHSACP technique (study group) were compared with another 50 patients randomly selected amongst those undergoing moderately hypothermic open heart procedures (control group). The data from successive clinical examinations and blood samplings were then compared to detect any sign of distal organ damage attributable to the MHSACP technique.

Results: The mortality rate did not differ between the two groups (2%). The average cardiopulmonary bypass and aortic cross-clamping durations were 154+/-53 min versus 102+/-25 min and 101+/-41 min versus 70+/-31 min for the study and control groups, respectively. The mean MHSACP period was 32+/-14 min (11-81 min) in the study group. The average discharge time was 6.4+/-1.4 days (5-12 days). Repeated clinical examinations revealed no organ dysfunction and there was no difference between the two groups (with the exception of lactate dehydrogenase) with regard to compared biochemical markers, which might be suggestive of a visceral damaging effect of the MHSACP technique.

Conclusions: The present data show that with the use of MHSACP, distal organs are relatively well protected during aortic arch repairs.