NEW TECHNIQUE FOR RETROGRADE CEREBRAL PERFUSION DURING ARCH ANEURYSM REPAIR

Many techniques are used to reduce brain damage during surgery for dis secting aneurysms of the ascending aorta and arch. Recently, new techn iques of protection were proposed, consistent with hypothermic circula tory arrest in association with retrograde cerebral perfusion via supe rior vena cava. We propose a simple, time-saving method, which does no t require any manipulation of the heart. We use a multilumen cannula f or cardioplegia (D 860-DIDECO FUNDARO') with pressure transducer. This cannula is inserted in superior vena cava by means of a simple purse- string, and linked to the arterial line with a ''Y'' derivation, allow ing retrograde perfusion of the brain and monitoring the perfusion pre ssure at every moment. The superior vena cava placed downstream from t he cannula is closed by a small vascular clamp, to avoid blood reflux in the right atrium. This method is time- and money-saving, is readily available, and can be prepared whenever necessary, also in the middle of the surgical procedure.