Near-infrared spectroscopy reveals asymmetric hemispheric blood supply during aortic arch surgery

Multichannel contrast-enhanced near-infrared spectroscopy in 10 aortic arch surgery patients shows left–right hemispheric bolus timing asymmetry, with left peaking later by +7.2 s during bilateral SACP.

• Why it matters: Current monitoring cannot directly verify whether bilateral or trilateral selective antegrade cerebral perfusion delivers symmetric hemispheric blood supply, leaving uncertainty about configuration-dependent timing.
• What they did: In a prospective pilot offline analysis, 10 patients received 94 indocyanine green boluses across 10 perfusion configurations, and interhemispheric time-to-peak differences (ΔTTP) were tested against baseline with a linear mixed model.
• The result: ΔTTP detected 6 of 9 configuration effects, and left timing reversed when both left arch vessels were on body perfusion; three patients with cerebral injury had the largest reversals, though p = 0.100.

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