Neuroprotection Strategies in Aortic Surgery

Abstract

Neurologic injury is a potentially devastating complication of aortic surgery. The methods used in aortic surgery, including systemic cooling, initiation of circulatory arrest, and rewarming during the replacement of the aortic arch, are the most complex circulatory management and surgical procedures performed in modern-day surgery. Despite the plethora of published literature, neuroprotection in aortic surgery is largely based on observational studies and institutional-based practices. This article summarizes the current evidence and emerging strategies for neuroprotection in aortic arch operations.

Keywords: Antegrade cerebral perfusion; Brain oximetry; Circulatory arrest; Deep hypothermic circulatory arrest; Near-infrared spectroscopy; Neurologic monitoring; Neuroprotection; Retrograde cerebral perfusion.