Comparison b/w antegrade and retrograde cerebral perfusion or profound hypothermia as brain protection strategies during repair of type A aortic dissection

from university of Iowa hospitals and clinics :

During surgical repair of type A aortic dissection, ACP,RCP, or DHCA have acceptable morbidity and mortality in selected patients.

The presence of hemodynamic instability prior to surgery and prolonged CPB time increases the risk of early and late mortality regardless of cerebral protection strategy.

Ann Cardiothoracic Surg 2016;5(4): 328-335

comment : selective antegrade brain perfusion 目前為本院使用模式,請大家要熟悉

2016 ESC Heart Failure Guideline

please search online guideline for reference

Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery

Transamin in CABG

1. lower risk of bleeding
2. without higher risk of death or thrombo-embolic events in 30 days post-op
3. higher risk of post-op seizure

Oct 23,2016 Doi:0.1056
NEJM oa1606424

comment: 本院 CPB使用 transamin 的時機為 pre- and post- CPB
                  dosage : 20mg/kg each

Acute Aortic Dissection and Intramural Hematoma : A systemic review

根據 Columbia university medical center, New York :

AAS (acute aortic syndrome)
type A : surgical repair
type B : TEVAR


JAMA 2016 ;316(7):754-763

comment: IMH-A 可採保守治療,但要很小心觀察