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The Annals of Thoracic Surgery, Vol 53, 47-53, Copyright © 1992 by The Society of Thoracic Surgeons
A Usui, T Hotta, M Hiroura, M Murase, M Maeda, T Koyama, M Tanaka, E Takeuchi, K Yasuura and T Watanabe
Retrograde cerebral perfusion through a superior vena caval cannula is a
new technique for protecting the brain during aortic arch operations. In
mongrel dogs (n = 10; 13 to 15 kg) we have performed retrograde cerebral
perfusion (300 mL/min) by infusing blood through a superior vena caval
cannula with aortic and inferior vena caval drainage. We have measured the
cerebral tissue blood flow, oxygen consumption, and carbon dioxide
exudation during retrograde cerebral perfusion at normothermia (NT, 37
degrees C) and hypothermia (HT, 20 degrees C) and have compared these
values with values obtained in dogs during cardiopulmonary bypass (1,200
mL/min). Cerebral tissue blood flow was measured by the hydrogen clearance
method. During retrograde cerebral perfusion about 20% of the superior vena
caval perfusate was returned through the aorta and the rest drained from
the inferior vena cava. Cerebral vascular resistance during retrograde
cerebral perfusion was lower than that during cardiopulmonary bypass (NT,
63.8 +/- 52.5 versus 126.9 +/- 58.4; HT, 28.4 +/- 32.8 versus 69.5 +/- 28.7
x 10(3) dynes.s.cm(-5). Retrograde cerebral perfusion provided half the
cerebral tissue blood flow of cardiopulmonary bypass (NT, 14.7 +/- 6.4
versus 34.3 +/- 7.8; HT, 17.6 +/- 5.6 versus 37.2 +/- 10.6 mL/min).
Retrograde cerebral perfusion also provided a third of the oxygen (NT, 4.4
+/- 2.1 versus 12.3 +/- 7.1; HT, 1.4 +/- 0.8 versus 4.2 +/- 1.3 mL/min) and
discharged 20% of the carbon dioxide (NT, 0.24 +/- 0.08 versus 1.19 +/-
0.58; HT, 0.15 +/- 0.06 versus 0.51 +/- 0.17 mmol/min) when compared with
cardiopulmonary bypass. Retrograde cerebral perfusion may reduce ischemic
damage during interruption of cerebral blood flow.
ARTICLES
Retrograde cerebral perfusion through a superior vena caval cannula protects the brain
Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.
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A. Usui, K. Oohara, T.-l. Liu, M. Murase, M. Tanaka, E. Takeuchi, and T. Abe Determination of optimum retrograde cerebral perfusion conditions J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 300 - 308. [Abstract] [Full Text]
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