Brain protection during aortic arch surgery: current state of problem
https://doi.org/10.24884/0042-4625-2025-184-1-99-106
Abstract
Aortic arch surgery is one of the most challenging field of cardiovascular surgery. Reconstructive interventions on the aortic arch are associated with high risks due to the peculiarities of anatomy and technical complexity of surgical intervention. Antegrade cerebral perfusion in combination with hypothermia is widely used to protect the brain during aortic arch surgery. Antegrade cerebral perfusion can be performed in unilateral or bilateral way. Now, there is no clear guidelines regarding the management of patients operated on the aortic arch. This review highlights the main methods of protecting the brain during aortic arch surgery and shows the results of the studies comparing antegrade unilateral brain perfusion with bilateral one. We reviewed rationale of various researchers in choosing two proposed methods to reduce the risk of neurological complications.
About the Authors
D. V. Khomushku
National Medical Research Center named after Academician E. N. Meshalkin
Russian Federation
Competing Interests:
Russian Federation
Khomushku Dadar-ool V., Postgraduate Student of the Department of Surgery of the Aorta and Coronary Arteries
15, Rechkunovskaya str., Novosibirsk, 630055
Competing Interests:
The authors declare no conflict of interest.
D. A. Sirota
National Medical Research Center named after Academician E. N. Meshalkin; Novosibirsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Sirota Dmitry A., Dr. of Sci. (Med.), Head of the Research Department of Surgery of the Aorta, Coronary and Peripheral Arteries of the Institute of Circulatory Pathology, Cardiovascular surgeon, Department of Aortic and Coronary Artery Surgery, National Medical Research Center named after Academician E. N. Meshalkin; Assistant of the Department of Cardiovascular Surgery, Faculty of Advanced Training and Professional Retraining, Novosibirsk State Medical University
15, Rechkunovskaya str., Novosibirsk, 630055
52, Krasny pr., Novosibirsk, 630091
Competing Interests:
The authors declare no conflict of interest.
A. A. Shadanov
National Medical Research Center named after Academician E. N. Meshalkin
Russian Federation
Competing Interests:
Russian Federation
Shadanov Aldar A., Cardiovascular Surgeon, Department of Aortic and Coronary Artery Surgery
15, Rechkunovskaya str., Novosibirsk, 630055
Competing Interests:
The authors declare no conflict of interest.
A. G. Edemskiy
National Medical Research Center named after Academician E. N. Meshalkin
Russian Federation
Competing Interests:
Russian Federation
Edemskiy Alexander G., Cand. of Sci. (Med.), Cardiovascular Surgeon of the Department of Surgery of the Aorta and Coronary Arteries
15, Rechkunovskaya str., Novosibirsk, 630055
Competing Interests:
The authors declare no conflict of interest.
A. M. Chernyavskiy
National Medical Research Center named after Academician E. N. Meshalkin; Novosibirsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Chernyavskiy Alexander M., Dr. of Sci. (Med.), Professor, Corresponding Member of the RAS, Honored Scientist of the Russian Federation, General Director, National Medical Research Center named after Academician E. N. Meshalkin; Head of the Department of Cardiovascular Surgery, Faculty of Advanced Training and Professional Retraining of Physicians, Novosibirsk State Medical University
15, Rechkunovskaya str., Novosibirsk, 630055
52, Krasny pr., Novosibirsk, 630091
Competing Interests:
The authors declare no conflict of interest.
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Review
For citations:
Khomushku D.V., Sirota D.A., Shadanov A.A., Edemskiy A.G., Chernyavskiy A.M. Brain protection during aortic arch surgery: current state of problem. Grekov's Bulletin of Surgery. 2025;184(1):99-106. (In Russ.) https://doi.org/10.24884/0042-4625-2025-184-1-99-106
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