| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 1995;109:259-268
© 1995 Mosby, Inc.
CARDIOPULMONARY BYPASS, |
Ann Arbor, Mich.
From the University of Michigan Medical Center, Section of Thoracic Surgery, Perfusion Services, and Department of Radiology, Ann Arbor, Mich.
Address for reprints: G. Michael Deeb, MD, 1500 E. Medical Center Dr., Box 0344, Ann Arbor, MI 48109.
Abstract
Hypothermic circulatory arrest has become an accepted technique for a variety of cardiac and complex aortic operations. However, prolonged periods (>45 min) of hypothermic circulatory arrest in older patients is associated with marginal cerebral protection and an increased inicidence of adverse neurologic events. In an effort to minimize such morbidity, we used a technique of retrograde cerebral perfusion with continuous monitoring of cerebral hemoglobin oxygen saturation during hypothermic circulatory arrest in 35 patients who understand thoracic aortic operations or resection of intracardiac tumor. There were 27 men and 8 women (mean age 60 years, range 21 to 83 years). Sixteen patients has acute dissection, 6 had contained rupture of a thoracic aortic aneurysm, 10 had total either a chronic dissection or aneurysm and 3 had hypernephromas, extending into the heart. Six patients underwent root replacement by means of an open technique for their distal anastomosis, 7 underwent root and partial arch replacement, 12 had root and total arch replacement, 7 had total arch replacemetn, and 3 had resection of tumor in the heart and retrohepatec vena cava. Seven vessels, and 2 patients had a cesarean section. Sixteen cases were emergency, 6 urgent, and 13 elective. Nine (26%) were reoperations. Thrity-four patients underwent the procedure via a median sternotomy and one patient through a posterolateral thoracotomy. The mean retrograde cerebral perfusion time was 63 minutes (range 35 to 128 minutes), with 30 (86%) patients having more than 45 minutes, 12 (34%) having more than 65 minutes, and 4 (11%) having more than 90 minutes. There was 1 operative death caused by preoperative myocardial infraction from an aortic dissection, and there were 2 late deaths (multiple organ failure and ruptured total aortic aneurysm). One patient had a stroke with a residual right hemiplegia and a pronounced aphasia. There were no other significant neurologic events or reoperations for bleeding. The average length of stay for patients having elective operations was 11 days and for those having emergency operations, 27 days. At a mean follow-up of 6 months all surviving patients (91%) are well. Hypothermic circulatory arrest is a relatively simple technique that provides a bloodless field and good visualization without the need for aortic crossclamps. Moreover, retrograde cerebral perfusion with continuous monitoring of cerebral oxygen saturation extends the "safe" time for hypothermic circulatory arrest, allowing ample opportunity to perform complicated cardiac operations with reduced risk of adverse neurologic events. (J THORAC CARDIOVASC SURG1995;109-259-68)
This article has been cited by other articles:
|
|
 |
|
  J. W. Hammon Extracorporeal Circulation: Perfusion System Card. Surg. Adult, January 1, 2008; 3(2008): 350 - 370. [Full Text]
|
|
|
|
 |
|
 A. Gega, J. A. Rizzo, M. H. Johnson, M. Tranquilli, E. A. Farkas, and J. A. Elefteriades Straight Deep Hypothermic Arrest: Experience in 394 Patients Supports Its Effectiveness as a Sole Means of Brain Preservation Ann. Thorac. Surg., September 1, 2007; 84(3): 759 - 767. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kunzli, P. O. Zingg, G. Zund, B. Leskosek, and L. K. von Segesser Does retrograde cerebral perfusion via superior vena cava cannulation protect the brain? Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 906 - 909. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. LeMaire, L. N. Ochoa, L. D. Conklin, R. A. Widman, F. J. Clubb Jr, A. Undar, Z. C. Schmittling, X. L. Wang, C. D. Fraser Jr, and J. S. Coselli Transcutaneous near-infrared spectroscopy for detection of regional spinal ischemia during intercostal artery ligation: preliminary experimental results. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1150 - 1155. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Estrera, Z. Garami, C. C. Miller III, R. Sheinbaum, T. T.T. Huynh, E. E. Porat, B. S. Allen, and H. J. Safi Cerebral monitoring with transcranial Doppler ultrasonography improves neurologic outcome during repairs of acute type A aortic dissection J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 277 - 285. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. T. Klodell, P. J. Hess, T. M. Beaver, D. Clark, and T. D. Martin Distal Aortic Perfusion During Aortic Arch Reconstruction: Another Tool for the Aortic Surgeon Ann. Thorac. Surg., December 1, 2004; 78(6): 2196 - 2198. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Estrera, Z. Garami, C. C. Miller III, R. Sheinbaum, T. T. T. Huynh, E. E. Porat, A. Winnerkvist, and H. J. Safi Determination of cerebral blood flow dynamics during retrograde cerebral perfusion using power M-mode transcranial Doppler Ann. Thorac. Surg., September 1, 2003; 76(3): 704 - 710. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ohata, T. Sakakibara, H. Takano, and T. Ishizaka Total arch replacement for thoracic aortic aneurysm via median sternotomy with or without left anterolateral thoracotomy Ann. Thorac. Surg., June 1, 2003; 75(6): 1792 - 1796. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Bhan, S. K. Chaudhary, R. Sharma, M. Hote, R. Gupta, and P. Venugopal Modified Circuit for Retrograde Cerebral Perfusion Asian Cardiovasc Thorac Ann, March 1, 2003; 11(1): 85 - 86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Hessel II and L. H. Edmunds Jr. Extracorporeal Circulation: Perfusion Systems Card. Surg. Adult, January 1, 2003; 2(2003): 317 - 338. [Full Text]
|
|
|
|
|
|
A. L. Estrera, C. C. Miller III, T. T.T. Huynh, E. E. Porat, and H. J. Safi Replacement of the ascending and transverse aortic arch: determinants of long-term survival Ann. Thorac. Surg., October 1, 2002; 74(4): 1058 - 1065. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Moon and T. M. Sundt III Influence of retrograde cerebral perfusion during aortic arch procedures Ann. Thorac. Surg., August 1, 2002; 74(2): 426 - 431. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K. Choudhary, R. Joshi, A. Bhan, and P. Venugopal Simplified technique for retrograde cerebral perfusion during repair of distal aortic arch and proximal descending thoracic aorta Ann. Thorac. Surg., August 1, 2002; 74(2): 606 - 608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Reents, W. Muellges, D. Franke, J. Babin-Ebell, and O. Elert Cerebral oxygen saturation assessed by near-infrared spectroscopy during coronary artery bypass grafting and early postoperative cognitive function Ann. Thorac. Surg., July 1, 2002; 74(1): 109 - 114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Harrington, C. H. Wong, and R. S. Bonser Neurological Complications of Aortic Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2002; 6(1): 7 - 16. [Abstract] [PDF]
|
|
|
|
|
|
Y. Kakihana, A. Matsunaga, K. Tobo, S. Isowaki, M. Kawakami, I. Tsuneyoshi, Y. Kanmura, and M. Tamura Redox behavior of cytochrome oxidase and neurological prognosis in 66 patients who underwent thoracic aortic surgery Eur. J. Cardiothorac. Surg., March 1, 2002; 21(3): 434 - 439. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Ehrlich, C. Hagl, J. N. McCullough, N. Zhang, H. Shiang, C. Bodian, and R. B. Griepp Retrograde cerebral perfusion provides negligible flow through brain capillaries in the pig J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 331 - 338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. LeMaire, J. K. Bhama, Z. C. Schmittling, P. J. Oberwalder, C. Koksoy, S. A. Raskin, P. E. Curling, and J. S. Coselli S100{beta} correlates with neurologic complications after aortic operation using circulatory arrest Ann. Thorac. Surg., June 1, 2001; 71(6): 1913 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Higami Reply Ann. Thorac. Surg., May 1, 2000; 69(5): 1643 - 1643. [Full Text] [PDF]
|
|
|
|
|
|
T. Kazui, N. Washiyama, B. A. H. Muhammad, H. Terada, K. Yamashita, M. Takinami, and Y. Tamiya EXTENDED TOTAL ARCH REPLACEMENT FOR ACUTE TYPE A AORTIC DISSECTION: EXPERIENCE WITH SEVENTY PATIENTS J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 558 - 565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Grabenwoger, D. Hutschala, M. P. Ehrlich, F. Cartes-Zumelzu, S. Thurnher, J. Lammer, E. Wolner, and M. Havel Thoracic aortic aneurysms: treatment with endovascular self-expandable stent grafts Ann. Thorac. Surg., February 1, 2000; 69(2): 441 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Shin’oka, G. Nollert, D. Shum-Tim, A. du Plessis, and R. A. Jonas Utility of near-infrared spectroscopic measurements during deep hypothermic circulatory arrest Ann. Thorac. Surg., February 1, 2000; 69(2): 578 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. O. de Salazar and J. L. Izaguirre Cerebral perfusion and transcranial Doppler Ann. Thorac. Surg., January 1, 2000; 69(1): 319 - 319. [Full Text] [PDF]
|
|
|
|
|
|
H. Ogino, Y. Ueda, T. Sugita, K. Morioka, Y. Sakakibara, K. Matsubayashi, and T. Nomoto Monitoring of regional cerebral oxygenation by near-infrared spectroscopy during continuous retrograde cerebral perfusion for aortic arch surgery Eur. J. Cardiothorac. Surg., October 1, 1999; 14(4): 415 - 418. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C H Wong and R S Bonser Retrograde cerebral perfusion: clinical and experimental aspects Perfusion, July 1, 1999; 14(4): 247 - 256. [PDF]
|
|
|
|
|
|
Y. Ueda, Y. Okita, S. Aomi, H. Koyanagi, and S. Takamoto Retrograde cerebral perfusion for aortic arch surgery: analysis of risk factors Ann. Thorac. Surg., June 1, 1999; 67(6): 1879 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. M. Deeb, D. M. Williams, L. E. Quint, H. M. Monaghan, and M. J. Shea Risk analysis for aortic surgery using hypothermic circulatory arrest with retrograde cerebral perfusion Ann. Thorac. Surg., June 1, 1999; 67(6): 1883 - 1886. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. E. Quint, I. R. Francis, D. M. Williams, H. M. Monaghan, and G. M. Deeb Synthetic Interposition Grafts of the Thoracic Aorta: Postoperative Appearance on Serial CT Studies Radiology, May 1, 1999; 211(2): 317 - 324. [Abstract] [Full Text]
|
|
|
|
|
|
M. G. Katz, V. Khazin, A. Steinmetz, M. Sverdlov, A. Rabin, D. Chamovitz, A. Schachner, and A. J. Cohen Distribution of cerebral flow using retrograde versus antegrade cerebral perfusion Ann. Thorac. Surg., April 1, 1999; 67(4): 1065 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Higami, S. Kozawa, T. Asada, H. Obo, K. Gan, K. Iwahashi, and H. Nohara Retrograde cerebral perfusion versus selective cerebral perfusion as evaluated by cerebral oxygen saturation during aortic arch reconstruction Ann. Thorac. Surg., April 1, 1999; 67(4): 1091 - 1096. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Ogino, Y. Ueda, T. Sugita, Y. Sakakibara, K. Matsuyama, K. Matsubayashi, and T. Nomoto Retrograde Cerebral Perfusion for Aortic Arch Surgery in Octogenarians Asian Cardiovasc Thorac Ann, March 1, 1999; 7(1): 27 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Tanoue, R. Tominaga, Y. Ochiai, K. Fukae, S. Morita, Y. Kawachi, and H. Yasui Comparative study of retrograde and selective cerebral perfusion with transcranial Doppler Ann. Thorac. Surg., March 1, 1999; 67(3): 672 - 675. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Cheung, J. E. Bavaria, A. Pochettino, S. J. Weiss, D. K. Barclay, and M. M. Stecker Oxygen Delivery During Retrograde Cerebral Perfusion in Humans Anesth. Analg., January 1, 1999; 88(1): 8 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Calkavur, Y. Atay, T. Yagdi, M. Cikirikcoglu, L. Can, U. Gurcun, M. Ozbaran, O. Bilkay, and S. Buket Clinical Results of Retrograde Cerebral Perfusion in Treatment of Aortic Disease Asian Cardiovasc Thorac Ann, December 1, 1998; 6(4): 288 - 294. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Moshkovitz, T. E. David, M. Caleb, C. M. Feindel, and M. P.L. de Sa Circulatory arrest under moderate systemic hypothermia and cold retrograde cerebral perfusion Ann. Thorac. Surg., October 1, 1998; 66(4): 1179 - 1184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ohmi, K. Tabayashi, M. Hata, H. Yokoyama, M. Sadahiro, and H. Saito Brain damage after aortic arch repair using selective cerebral perfusion Ann. Thorac. Surg., October 1, 1998; 66(4): 1250 - 1253. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Juvonen, N. Zhang, D. Wolfe, D. J. Weisz, C. A. Bodian, H. H. Shiang, J. N. McCullough, and R. B. Griepp Retrograde cerebral perfusion enhances cerebral protection during prolonged hypothermic circulatory arrest: a study in a chronic porcine model Ann. Thorac. Surg., July 1, 1998; 66(1): 38 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pretre, N. Murith, D. Delay, and T. Kalonji Surgical Management of Hemorrhage From Rupture of the Aortic Arch Ann. Thorac. Surg., May 1, 1998; 65(5): 1291 - 1295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Ye, L. Yang, M. R. Del Bigio, R. Summers, D. Jackson, R. L. Somorjai, T. A. Salerno, and R. Deslauriers RETROGRADE CEREBRAL PERFUSION PROVIDES LIMITED DISTRIBUTION OF BLOOD TO THE BRAIN: A STUDY IN PIGS J. Thorac. Cardiovasc. Surg., October 1, 1997; 114(4): 660 - 665. [Abstract] [Full Text]
|
|
|
|
|
|
M. Grabenwoger, M. Ehrlich, F. Cartes-Zumelzu, M. Mittlbock, G. Weigel, G. Laufer, E. Wolner, and M. Havel Surgical Treatment of Aortic Arch Aneurysms in Profound Hypothermia and Circulatory Arrest Ann. Thorac. Surg., October 1, 1997; 64(4): 1067 - 1071. [Abstract] [Full Text]
|
|
|
|
|
|
B. L. Ganzel, H. L. Edmonds Jr, J. R. Pank, and L. J. Goldsmith NEUROPHYSIOLOGIC MONITORING TO ASSURE DELIVERY OF RETROGRADE CEREBRAL PERFUSION J. Thorac. Cardiovasc. Surg., April 1, 1997; 113(4): 748 - 757. [Abstract] [Full Text]
|
|
|
|
|
|
K. Tayama, H. Akashi, S. Fukunaga, K. Kosuga, and S. Aoyagi Operation for Type B Aortic Dissection Using Hypothermic Selective Cerebral Perfusion Ann. Thorac. Surg., February 1, 1997; 63(2): 535 - 537. [Abstract] [Full Text]
|
|
|
|
|
|
J.-i. Hayashi, S. Eguchi, K. Yasuda, S. Komatsu, K. Tabayashi, M. Masuda, R. Yozu, K. Amemiya, E. Takeuchi, S. Nakano, et al. Aortic Arch Operation Using Selective Cerebral Perfusion for Nondissecting Thoracic Aneurysm Ann. Thorac. Surg., January 1, 1997; 63(1): 88 - 92. [Abstract] [Full Text]
|
|
|
|
|
|
R. M. Bojar, D. D. Payne, R. E. Murphy, S. L. Schwartz, J. R. Belden, L. R. Caplan, and H. Rastegar Surgical Treatment of Systemic Atheroembolism From the Thoracic Aorta Ann. Thorac. Surg., May 1, 1996; 61(5): 1389 - 1393. [Abstract] [Full Text]
|
|
|
|
|
|
M. E. Yerlioglu, D. Wolfe, C. K. Mezrow, D. J. Weisz, P. S. Midulla, N. Zhang, H. H. Shiand, C. Bodian, and R. B. Griepp THE EFFECT OF RETROGRADE CEREBRAL PERFUSION AFTER PARTICULATE EMBOLIZATION TO THE BRAIN J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1470 - 1485. [Abstract] [Full Text]
|
|
|
|
|
|
B. W. Lytle, P. M. McCarthy, K. M. Meaney, R. W. Stewart, and D. M. Cosgrove III Systemic hypothermia and circulatory arrest combined with arterial perfusion of the superior vena cavaEffective intraoperative cerebral protection J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 738 - 743. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
