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Ann Thorac Surg 2002;73:S366
© 2002 The Society of Thoracic Surgeons

SUPPLEMENT: OUTCOMES 2001: SCIENTIFIC ABSTRACTS

Impact of retrograde cerebral perfusion on S100ß release during hypothermic circulatory arrest for thoracic aortic surgery

J.K. Bhama, MDa, S.A. LeMaire, MDa, P.J. Oberwalder, MDa, Z.C. Schmittling, MDa, S.A. Raskin, CCPa, J.S. Coselli, MDa

a Baylor College of Medicine and the Methodist DeBakey Heart Center, Houston, Texas, USA

Introduction. The efficacy of retrograde cerebral perfusion (RCP) as an adjunct for brain protection during hypothermic circulatory arrest (HCA) remains controversial. The purpose of this study was to use S100ß (a serum marker for cerebral injury) to evaluate the impact of RCP during thoracic aortic surgery

Methods. Thirty-seven adult patients undergoing thoracic aortic surgery using HCA were evaluated. RCP was used during HCA in 25 patients (68%). Blood was collected preoperatively, 30 minutes after cardiopulmonary bypass (CPB), and 24 hours postoperatively; S100ß levels were measured using a standard immunoradiometric assay.

Results. Patients in the RCP and non-RCP groups had similar CPB times (125 ± 47 vs 135 ± 20 minutes, p = 0.376), HCA times (34 ± 13 vs 35 ± 14 minutes, p = 0.80), and baseline S100ß levels (0.09 ± 0.12 vs 0.09 ± 0.08 µg/L, p = 0.827). S100ß levels were significantly elevated 30 minutes after CPB and 24 hours postoperatively in both groups. RCP did not reduce S100ß levels 30 minutes after CPB (3.76 ± 2.28 µg/L with RCP vs 4.22 ± 2.79 µg/L without RCP, p = 0.599) or at 24 hours postoperatively (0.83 ± 1.69 µg/L with RCP vs 0.53 ± 0.38 µg/L without RCP, p = 0.413).

Conclusions. RCP does not significantly affect S100ß release during HCA in patients undergoing thoracic aortic surgery. Using serum S100ß as a marker for brain injury, RCP does not provide improved cerebral protection over HCA alone.





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