Deep Hypothermic Circulatory Arrest in Cardiovascular Surgery
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Questions and Answers

What type of aortic dissection may require femoral, innominate or right axillary arterial cannulation?

  • Degenerative aortic aneurysm
  • Chronic Type A
  • Acute Type A (correct)
  • Type B
  • What is one benefit of femora-femoral or axillo-femoral CPB?

  • Reducing the risk of atheroembolism
  • Increasing cerebral perfusion pressure
  • Restoring anterograde flow
  • Permitting systemic cooling prior to sternotomy (correct)
  • Why may cannulation of the mid or distal aortic arch be required?

  • To permit systemic cooling
  • To ensure adequate cerebral venous drainage
  • To reduce the risk of atheroembolism (correct)
  • To restore anterograde flow
  • What is necessary for retrograde cerebral perfusion (RCP) with reversal of blood flow in the superior vena cava?

    <p>Bicaval cannulation</p> Signup and view all the answers

    What is the purpose of bicaval cannulation in anterograde cerebral perfusion?

    <p>To ensure adequate cerebral venous drainage</p> Signup and view all the answers

    What is the potential consequence of inadequate cerebral venous drainage in anterograde cerebral perfusion?

    <p>Cerebral edema</p> Signup and view all the answers

    What is the term for the technique of core cooling combined with cessation of blood flow?

    <p>Deep hypothermic circulatory arrest</p> Signup and view all the answers

    What is the primary reason for using deep hypothermic circulatory arrest in certain surgeries?

    <p>To provide a bloodless field for dissection</p> Signup and view all the answers

    What is the benefit of reducing the body temperature to 30°C during surgery?

    <p>It increases the period of 'safe’ cerebral ischemia</p> Signup and view all the answers

    Who demonstrated that a reduction in body temperature to 30°C increased the period of 'safe’ cerebral ischemia?

    <p>Bigelow</p> Signup and view all the answers

    What was used for surface cooling in early experiments?

    <p>Cold rubber blankets</p> Signup and view all the answers

    What is the term for the temporary stopping of the heart during surgery?

    <p>Cardioplegia</p> Signup and view all the answers

    What type of pump is preferred in DHCA to reduce damage to cellular components and hemolysis?

    <p>Centrifugal pump</p> Signup and view all the answers

    What is the primary purpose of incorporating a hemofilter in the extracorporeal circuit during DHCA?

    <p>To permit hemoconcentration during rewarming</p> Signup and view all the answers

    Why is a cardiotomy reservoir of sufficient capacity selected in DHCA?

    <p>To accommodate the circulating volume during exsanguination</p> Signup and view all the answers

    What is the approximate energy required to warm a 70-kg adult from 20°C to 37°C?

    <p>4.2 MJ (1000 kcal)</p> Signup and view all the answers

    Why is consideration given to the use of heparin-bonded circuits in DHCA?

    <p>In cases requiring prolonged CPB</p> Signup and view all the answers

    What is the average specific heat capacity of human tissue?

    <p>3.5 kJ kg⁻¹ °C⁻¹ (0.83 kcal kg⁻¹ °C⁻¹)</p> Signup and view all the answers

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