The Aortic Surgery Cerebral Protection Evaluation Randomized Trial
The ACE CardioLink-3 Trial

Aortic surgery often requires temporarily stopping the heart and ceasing blood flow. In doing so, the brain and other critical organs become vulnerable to damage due to oxygen deprivation.  To prevent potential brain damage, the patient's core body temperature is artificially cooled to minimize whole-body oxygen requirements.  At the same time, a temporary circulatory system is established via axillary cannulation (through an artery in the armpit) to keep blood flowing through the brain during the surgical window. A more recently developed method of perfusing the brain that involves innominate cannulation (a different artery that is closer to the heart) that may potentially reduce surgical time and post-operative recovery/complications.  Using the gold-standard magnetic resonance imaging (MRI), the ACE CardioLink-3 study team compared the safety and efficacy of innominate cannulation to axillary cannulation for cerebral protection during aortic surgery. The study found that the former technique was safe and provided comparable neuroprotection to the latter strategy. The results were first presented at the 2019 Annual Meeting of the American Association for Thoracic Surgery (AATS) and published in the JTCVS.