Method unilateral antegrade selective cerebral perfusion during operations on the aortic arch in children

摘要

Method unilateral antegrade selective cerebral perfusion in the aortic arch in children operations consisting in that, before the operation is performed catheterization of the right beam and one of the femoral arteries for direct manometry install sensors cerebral and renal regional oximetry monitoring venous saturation, after which operate access to the heart and great vessels through a median sternotomy, performed cardiopulmonary bypass connection according to the "aorta, vena cava 'or' AOP and-right atrium ", characterized in that the patient begin cooling to moderate hypothermia 28-32 ° C, isolated aortic arch branches, brachiocephalic trunk take the turnstile pouch for dissolving aortic cannula, the cannula is advanced into the aortic lumen brachiocephalic trunk, not reaching bifurcation of the right common carotid artery and the right subclavian artery, aortic pouch tightened further occluded ascending aorta, the cardioplegia-operate, reduces the volumetric flow rate of perfusion to 25-30% occluded left common carotid artery and left conn chichnuyu artery, brachiocephalic trunk squeeze turnstile, and then operate the main stage of operation, after which take measures for the prevention of air embolism, dissolving turnstile at brachiocephalic trunk, remove the clips from the left common carotid artery and left subclavian artery, the pouch at the aortic cannula relaxes, the aortic cannula is moved into the lumen of the ascending aorta, aortic pouch delay, increase the volume of 100% perfusion, start warming the patient to normothermia.