Selective cerebral perfusion with 4-branch graft total aortic arch replacement: Outcomes in 12 patients

Wei Liang Lai, Chiao Po Hsu, Chung Che Shih, Ming Li Li, Ping chun Li

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Background: Aortic arch reconstruction is associated with high neurological morbidity. Our purpose is to describe our experience using a 4-branched graft and selective antegrade brain perfusion (SABP) for total aortic arch replacement (TAR).Methods: We retrospectively reviewed the medical records of 12 patients who received TAR, with or without ascending aorta replacement, with a 4-branched graft for Stanford type A dissection (n = 9) or aortic arch aneurysm (n = 3). In all patients surgery was performed with deep hypothermic circulatory arrest (DHCA) with or without retrograde brain perfusion, and selective antegrade brain perfusion (SABP) via the subclavian artery or axillary artery.Results: There were 8 males and 4 females with an average age of 63.14 years. Emergent operations were performed in 9 patients with acute type A aortic dissections. Of all 12 patients, 2 deaths occurred and 1 patient experienced lower extremity paraplegia resulting in an in-hospital mortality rate of 16.6% and a permanent neurological deficit rate of 8.3%.Conclusions: The use of a 4-branched graft, hypothermic circulatory arrest, and SABP is a useful operative method for aortic arch replacement with acceptable morbidity and mortality.

Original languageEnglish
Article number32
JournalJournal of Cardiothoracic Surgery
Issue number1
Publication statusPublished - Apr 13 2012
Externally publishedYes


  • Aortic arch aneurysm
  • Branched aortic graft
  • Type A aortic dissection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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