Tools and Tricks in Monitoring the Brain During Arch Surgery
While performing aortic arch surgery, it is mandatory to rely on a safe neuroprotective strategy to avoid cerebral damage, the most dreadful complication after repair of the arch. This can only be achieved by a combination of different modalities.
Moderate (25 degrees Celsius rectal temperature) to deep (18 degrees Celsius or lower rectal temperature) cooling of the body during extracorporeal circulation is a cornerstone as well as the antegrade cerebral perfusion, the latter especially in complex arch reconstructions. While time limits the use of deep hypothermic circulatory arrest to about 30 minutes, there are almost no time restrictions when using antegrade selective cerebral perfusion.