An interventional study of Antegrade Perfusion and Retrograde Perfusion in Brain Function and Hemiarch Cardiac Procedure, sponsored by Duke University. Recruiting at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-03.
Sponsored by Duke University · Not applicable, Interventional, and Prevention
The purpose of this study is to compare brain function after surgical circulatory arrest using either antegrade perfusion or retrograde perfusion.
The purpose of this study is to compare brain function after surgical circulatory arrest (surgeon stops the heart-lung machine to work on the heart) in antegrade perfusion versus retrograde perfusion. There are 2 ways to supply blood to the brain, antegrade and retrograde perfusion. In antegrade perfusion, the surgeon accesses one of two arteries that branch off from the aorta (the artery that delivers blood to the rest of the body) to provide blood to the brain. In retrograde perfusion, the surgeon accesses the superior vena cava (large vein bringing blood back to the heart) to supply blood to the brain.
It is standard practice to cool the patient down during this type of surgery to help protect the brain. Despite measures to safeguard brain health, some patients still experience postoperative cognitive decline such as confusion, delirium and agitation. The investigators are conducting this study to see which method of perfusing the brain is superior and decreases the symptoms of confusion, delirium and agitation.
Duke University is the lead sponsor of 2,025 studies on the registry; 275 are open to participants now.
Of its 194 completed or terminated interventional studies of FDA-regulated products, 159 (82%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
In antegrade perfusion, the surgeon accesses one of two arteries that branch off from the aorta (the artery that delivers blood to the rest of the body) to provide blood to the brain.
Procedure: Antegrade Perfusion
In retrograde perfusion, the surgeon accesses the superior vena cava (large vein bringing blood back to the heart) to supply blood to the brain.
Procedure: Retrograde Perfusion
Procedure in which the surgeon accesses one of two arteries that branch off from the aorta to provide blood to the brain.
Procedure in which the surgeon accesses the superior vena cava to supply blood to the brain.
Change in neurocognitive function as measured by the Montreal Cognitive Assessment (MoCA)
The MoCA is a brief screening tool used to assess cognitive function. It consists of 30 tasks covering various cognitive domains, including attention, memory, visuospatial abilities, and executive function. The total score ranges from 0 to 30, where a higher score indicates better cognitive function.
Time frame: Baseline to 4 weeks
Effect of Antegrade Perfusion (ACP) vs Retrograde Perfusion (RCP) on brain white matter patency
Measured by MRI at baseline, prior to discharge, and at 4 weeks.
Time frame: Baseline, prior to discharge from hospital (up to 7 days), and at 4 weeks
Effect of Antegrade Perfusion (ACP) vs Retrograde Perfusion (RCP) on functional connectivity
Measured by MRI at baseline and at 4 weeks.
Time frame: Baseline and at 4 weeks
Plan to share: Yes
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