Neuroprotection during Open Aortic Arch Surgery: Cerebral Perfusion Methods and Temperature

Abstract

Neuroprotection is important in open aortic arch surgery because of the dependence of brain tissues on cerebral perfusion. Therefore, several techniques have been developed to reduce cerebral ischemia and improve outcomes in open aortic arch surgery. In this review, I describe various neuroprotective strate-gies, such as profound and deep hypothermic circulatory arrest, selective antegrade cerebral perfusion, retrograde cerebral perfusion, and lower body circulatory arrest; compare their advantages and disad-vantages, and discuss their evolution and current status by reviewing relevant literature. (J Nippon Med Sch 2023; 90: 11―19).