Re. Deep Hypothermic Circulatory Arrest
Re. Deep Hypothermic Circulatory Arrest
coryp said:
And exactly when and what it is used for?
I have heard this mentioned by the surgeons (knowing that it really increases the risk of stroke and cognitive malfunctions worries me).
Any insight would be greatly appreciated
Thank you
Hi Cory,
I sent you an email just now, with some links that may be helpful to you, including the aortic surgery page at Cedars, which has descriptive information about the various surgical options, etc. I thought it might be interesting to share some background on total circulatory arrest (also called hypothermic circulatory arrest) on this thread. I remember how confusing it was when we first heard about it!
A major breakthrough with this goes back a long time, to 1975, when Dr. Randall Griepp published results of four patients who underwent aortic arch surgery using it. This was very much pioneering work, and I feel very grateful to Dr. Griepp for this. Here is a link to that early paper, and a great deal has been published in the years that have followed.
http://www.ncbi.nlm.nih.gov/entrez/...ed&dopt=Abstract&list_uids=1186283&query_hl=3
Many years later, when my husband needed aortic surgery, circulatory arrest with deep hypothermia was possible not only for the arch, but for the ascending aorta, and today it is also applied to the descending aorta. We were very fortunate that Dr. Raissi, who trained in Dr. Griepp's program in New York, had come out to LA, bringing this expertise here. My husband had his entire ascending aorta replaced by Dacron, and a small part underneath his arch. His circulatory arrest time was only 23 minutes. He did beautifully following surgery, with no adverse neurological affects at all, and even tho' he was on coumadin because of his mechanical valve (his valve replacement surgery was years before), he was able to go home on the third morning after surgery.
Arresting the blood flow allows the surgeon to work in a blood-free environment without clamping the aorta. The brain, which is brought to zero electrical activity, is protected by the very cold temperature. The metabolism of the cells and the demand for oxygen becomes so low that it is safe to stop the blood flow temporarily.
I hope this helps make things a little clearer. It is one of the things that you can discuss during an aortic surgical consult. This is one of the wonders of aortic surgery to me, and I am grateful that it was there when my husband needed it.
Best Wishes,
Arlyss