TECHNIQUES FOR RETROGRADE CEREBRAL PERFUSION IN THE TREATMENT OF AORTIC LESIONS VIA LEFT THORACOTOMY

Retrograde cerebral perfusion under deep hypothermic circulatory arres t is a simple and useful adjunct in aortic surgery and is performed by many surgeons in the treatment of aortic arch pathology. In recent ye ars, this technique has been recommended in the surgery of distal arch and proximal descending aortic lesions through a left thoracotomy inc ision. The aim of the technique is to increase the right atrial pressu re for retrograde cerebral perfusion. After cooling using femorofemora l bypass, circulatory arrest is initiated. The right atrial pressure i s increased to 20 mmHg, and retrograde cerebral circulation results. I n this article, five patients with distal aortic arch and proximal des cending thoracic aortic lesions who were operated on by using this tec hnique were evaluated. It is suggested that this technique can be used with a lateral thoracotomy approach that is suitable for procedures o n a distal aortic arch and proximal descending aorta.