Cannula malposition during antegrade cerebral perfusion for aortic surgery: role of cerebral oximetry.
Can J Anaesth
; 61(8): 736-40, 2014 Aug.
Article
en En
| MEDLINE
| ID: mdl-24866375
ABSTRACT
PURPOSE:
To describe the use of cerebral oximetry to detect a lack of right cerebral perfusion resulting from a malpositioned catheter used for antegrade cerebral perfusion during deep hypothermic circulatory arrest (DHCA). The simple corrective surgical adjustment that followed averted a potentially serious complication. CLINICAL FEATURES A 57-yr-old male with a type-A aortic dissection undergoing DHCA required antegrade cerebral perfusion for cerebral protection. Catheters were placed accordingly in the left common carotid and brachiocephalic arteries. Whereas frontal cerebral oximetry immediately improved on the left, it did not improve on the right. It was immediately suspected that the tip of the brachiocephalic cannula had advanced into the right subclavian artery, thus depriving the right common carotid artery of blood flow. The problem resolved upon slight withdrawal of the cannula.CONCLUSION:
Vigilance in anesthesia should not stop during DHCA or cardiopulmonary bypass. Cerebral oximetry may provide important information leading to actions that improve brain protection. Vigilances proved important in this case where the cannula tip used for antegrade cerebral perfusion was advanced too far into the right subclavian artery.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Encéfalo
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Oximetría
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Aneurisma de la Aorta Torácica
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Catéteres
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Disección Aórtica
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Can J Anaesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
China