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Protecting the brain during heart surgery

The aorta carries blood from the heart to the circulatory system. When it splits open, it usually means sudden death.

SAN ANTONIO, Texas — Aortic dissection is a tear in the aorta — the largest artery in the body. Because the aorta carries blood from the heart to the circulatory system, when it splits open, it usually means sudden death. For some patients lucky enough to make it into an operating room, surgeons are utilizing a ‘super cool-down’ of the body.

Cardiothoracic surgeon at Baptist Health System in San Antonio, Texas, Truc Ly, MD, explains, “Fifty percent of the time, people who present with dissection don’t make it to the hospital. Of the people who do make it to the hospital, only half of those survive.”

This means time is critical.

“The way we’ve gotten better results is understanding how to protect the brain during surgery. What we call antegrade cerebral protection,” Dr. Ly further explains.

Doctors do this by using hypothermia induction, which is cooling the body to preserve the brain during heart-lung bypass.

Dr. Ly says, “This what we call hypothermic circulatory arrest, it’s where we cool the body down and stop all blood flow to the rest of the body.”

Sandra Fernandez loves to spend time in her kitchen, but recently, surgeons needed to treat an aortic aneurysm. Dr. Ly removed Sandra’s aneurysm and replaced her heart valve during the operation. Doctors induced hypothermia to protect her brain function.

“Whatever we’ve been able to fix, will stay that way for the rest of her life,” Dr. Ly reassures.

Sandra woke up in recovery to a very happy family. Now, she’s enjoying life, cooking for her kids using her grandmother’s precious recipes.

“I feel happy because I say, ok, I’m here again, I survived!,” Sandra exclaims.

Acute aortic dissection can be sudden and is marked by intense chest pain. Each hour that someone delays going to the hospital, the mortality rate increases by one percent.

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