| Original language | English |
|---|---|
| Pages (from-to) | 44-51 |
| Number of pages | 8 |
| Journal | Annals of Thoracic Surgery |
| Volume | 114 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 2022 |
Bibliographical note
Funding Information:TA-NRP protocols require prevention of cerebral circulation to ensure permanent absence of brain function. Although it is relatively easy to prevent major vessel perfusion of the brain using ligation or balloon occlusion, collateral sources of blood flow might provide some degree of brain perfusion. Several methods have been advocated to ensure complete loss of brain circulation during TA-NRP procedures, including free drainage of aortic arch vessels to atmospheric or negative pressure, thus allowing collateral vessels, such as vertebral or spinal arteries, to drain to atmospheric pressure.13 Total absence of brain perfusion has not yet been proven definitively, but in the study from Manara and colleagues13 of 3 patients, persisting drainage of blood from the open ends of the arch vessels provides support for the presumption that ischemia is complete. Several possible means to substantiate absence of brain perfusion exist, but have not yet been systematically investigated in TA-NRP.28 For that reason, TA-NRP in the United States should be done under research protocols that include verification that perfusion of the brain stem is absent.
ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine