| Issue |
J Extra Corpor Technol
Volume 57, Number 3, September 2025
|
|
|---|---|---|
| Page(s) | 153 - 159 | |
| DOI | https://doi.org/10.1051/ject/2025011 | |
| Published online | 15 September 2025 | |
Case Report
An effective case of pulsatile flow for cerebral malperfusion of stanford type A aortic dissection
1
Department of Clinical Engineering, Kitaharima Medical Center, 926-250, Ichiba-cho, Ono-shi, Hyogo, 675-1392, Japan
2
Department of Cardiovascular Surgery, Kitaharima Medical Center, 926-250, Ichiba-cho, Ono-shi, Hyogo, 675-1392, Japan
* Corresponding author: tommo.tommo@outlook.jp
Received:
2
September
2024
Accepted:
31
March
2025
The surgical management of preoperative malperfusion poses considerable challenges, particularly in cases of acute type A aortic dissection (TAAD). Herein, we describe the case of a 78-year-old female patient presenting with TAAD complicated by malperfusion of the left lower extremity and an entry tear localized to the ascending aorta. During the initiation of cardiopulmonary bypass (CPB), a pronounced bilateral discrepancy in radial mean arterial blood pressure (mABP) was identified, alongside a significant reduction in cerebral tissue oxygenation index (TOI) and the oxyhemoglobin change rate (ΔHbO2). To mitigate the malperfusion, pulsatile flow (PF) was utilized during CPB. This report elucidates the meticulous application of PF during CPB in the management of this complex malperfusion scenario, culminating in a favorable postoperative outcome.
Key words: Malperfusion / Pulsatile flow / Aortic dissection / Near-infrared spectroscopic oximetry (NIRO)
© The Author(s), published by EDP Sciences, 2025
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