Controlled Earlier Reperfusion for Brain Ischemia Caused by Acute Type A Aortic Dissection Hiroshi Munakata, MD, Kenji Okada, MD, PhD, Hiroya Kano, MT,

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Controlled Earlier Reperfusion for Brain Ischemia Caused by Acute Type A Aortic Dissection Hiroshi Munakata, MD, Kenji Okada, MD, PhD, Hiroya Kano, MT, Sou Izumi, MD, Yutaka Hino, MD, Masamichi Matsumori, MD, PhD, Yutaka Okita, MD, PhD The Annals of Thoracic Surgery Volume 87, Issue 4, Pages e27-e28 (April 2009) DOI: 10.1016/j.athoracsur.2008.11.041 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 A simple bypass circuit was established from the femoral artery to the true lumen of the right common carotid artery in the emergency room. (F = false lumen of aortic dissection; Rt CCA = right common carotid artery; Rt FA = right femoral artery; T = true lumen of aortic dissection.) The Annals of Thoracic Surgery 2009 87, e27-e28DOI: (10.1016/j.athoracsur.2008.11.041) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Serial change of rSO2 during the procedure. (CPB = cardiopulmonary bypass; CRS = cerebral reperfusion system; rSO2 = brain oxygenation; SCP = selective cerebral perfusion.) The Annals of Thoracic Surgery 2009 87, e27-e28DOI: (10.1016/j.athoracsur.2008.11.041) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Serial brain computed tomographic (CT) scans and magnetic resonance imaging (MRI) showed large right cerebral infarctions; however, brain edema was minimized. (POD = postoperative day.) The Annals of Thoracic Surgery 2009 87, e27-e28DOI: (10.1016/j.athoracsur.2008.11.041) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions