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Colombian Journal of Anestesiology
versão impressa ISSN 0120-3347
Resumo
CASTRO, Hernán et al. A case report regarding the deep hypothermia and total circulatory arrest technique for clipping giant cerebral aneurysms. Rev. colomb. anestesiol. [online]. 2010, vol.38, n.1, pp.111-123. ISSN 0120-3347.
Deep hypothermia and total circulatory arrest technique for facilitating clipping complex posterior circulation cerebral aneurysms is not a new technique; however, this case report deals with the first case treated at the Hospital Santa Sofía in Manizales (Caldas) and in the Colombian coffee-growing area. Our team reports a 53-year-old female patient who underwent surgery to clip a giant basilar artery aneurysm; closed-chest extrathoracic cannulation for femorofemoral cardiopulmonary bypass was used, involving total circulatory arrest, deep hypothermia and heparin anticoagulation. Cardiac arrest lasted 15 minutes. The patient did not require conversion to sternotomy. Blood outflow via femoral vein was sufficient to maintain cardiopulmonary bypass and induce deep hypothermia (18°C, retention of spontaneous circulation, and propofol infusion (3-5 mg · kg-1 · h-1) under general anaesthesia, thereby facilitating easy clipping. No intraoperatorive complications were presented, such as ventricular fibrillation, ventricular dilatation or haemorrhage. Haemodynamics were controlled with neosinefrin. The patient was transferred (intubated) to the ICU.
Palavras-chave : Brain; protective agents; hypothermia; cardiopulmonary bypass; basilar artery aneurysm.