METHOD FOR ADEQUATE PERFUSION OF CEREBRUM IN OPERATIONS ON ASCENDING SEGMENT AND PORTION OF AORTIC ARCH WITHOUT CIRCULATORY ARREST Russian patent published in 2020 - IPC A61M25/10 A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to cardiovascular surgery. Performing vascular cannulation and initiating artificial circulation in moderated hypothermia 32 °C. Clamp is applied crosswise on the ascending aorta above the coronary artery mouths and cardioplegic Custodiol solution is antegrade injected. Brachiocephalic trunk cannula 16 Fr is cannulated with a side branch through which antegrade cerebral perfusion is performed at the time of clamping of the brachiocephalic arteries. Before the main stage of the operation on the artificial blood circulation at the systemic arterial pressure of 90 mm Hg. left common carotid artery is clamped for 5 minutes. That is followed by evaluating the dynamics of the cerebral oximetry values in the left hemisphere. If the cerebral oximetry values in the left hemisphere are lower than 40 % or 20 % or more of the initial value at the main stage of the operation, the bilateral antegrade perfusion of the brain is immediately performed. For bilateral antegrade perfusion, a Foley type catheter is introduced into the left common carotid artery with a line from a lateral branch of 16 Fr cannula in the brachiocephalic trunk with increase of perfusion volume rate to values of cerebral oximetry index in hemispheres to trial compression at systemic arterial pressure of 90 mm Hg. If there are no significant changes in the cerebral oximetry indices in the left hemisphere, initially unilateral antegrade perfusion of brain is performed through brachiocephalic trunk with increase of perfusion volume rate to achieve values of cerebral oximetry index in hemispheres to test compression at systemic arterial pressure of 90 mm Hg.

EFFECT: method enables performing the operations without circulatory arrest, protecting the central nervous system ensured by the controlled perfusion of the brain.

1 cl, 2 ex