JTCS Click here to go to SJM website.
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Mitsuhiro Kawata
Shinichi Takamoto
Yoshihiro Suematsu
Minoru Ono
Noboru Motomura
Tetsuro Morota
Arata Murakami
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kawata, M.
Right arrow Articles by Murakami, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kawata, M.
Right arrow Articles by Murakami, A.
Related Collections
Right arrow Extracorporeal circulation
Right arrow Great vessels

J Thorac Cardiovasc Surg 2006;132:933-940
© 2006 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

Retrograde cerebral perfusion with intermittent pressure augmentation provides adequate neuroprotection: Diffusion- and perfusion-weighted magnetic resonance imaging study in an experimental canine model

Mitsuhiro Kawata, MDa,*, Masaki Sekino, PhDb, Shinichi Takamoto, MD, PhDa, Shoogo Ueno, PhDb, Sachiko Yamaguchi, MSb, Kazuo Kitahori, MD, PhDa, Hiroyuki Tsukihara, MDa, Yoshihiro Suematsu, MD, PhDa, Minoru Ono, MD, PhDa, Noboru Motomura, MD, PhDa, Tetsuro Morota, MD, PhDa, Arata Murakami, MD, PhDa

a Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
b Department of Biomedical Engineering, Bioimaging and Biomagnetics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Received for publication October 24, 2005; revisions received March 6, 2006; accepted for publication March 28, 2006.

* Address for reprints: Mitsuhiro Kawata, MD, Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. (Email: mkawata-ths{at}umin.ac.jp).

Objective: Diffusion- and perfusion-weighted magnetic resonance imaging can identify ischemic brain injury in the hyperacute stage. For neuroprotection during thoracic aortic surgery, we developed a novel retrograde cerebral perfusion with intermittent pressure augmentation. The purpose of this study was to assess the efficiency of this novel method for neuroprotection in real time by using diffusion- and perfusion-weighted magnetic resonance imaging.

Methods: Sixteen beagle dogs were randomly divided into 4 groups: the antegrade selective cerebral perfusion group (n = 4; antegrade selective cerebral perfusion at a flow rate of 10 mL · kg–1 · min–1); the intermittent retrograde cerebral perfusion group (n = 4; retrograde cerebral perfusion at a baseline pressure of 15 mm Hg with intermittent pressure augmentation to 45 mm Hg every 30 seconds); the conventional retrograde cerebral perfusion group (n = 4; conventional retrograde cerebral perfusion at a fixed pressure of 25 mm Hg); and the circulatory arrest group (n = 4; only circulatory arrest). Diffusion- and perfusion-weighted magnetic resonance images were acquired during each session of cerebral perfusion. Regions of interest were defined, and the apparent diffusion coefficient and relative regional cerebral blood volume were calculated in these regions of interest. Finally, the brain was evaluated for its histopathologic damage score.

Results: The best apparent diffusion coefficient values were observed in the intermittent retrograde cerebral perfusion group in all the regions of interest, although the relative regional cerebral blood volume values were mostly lower than those in the antegrade selective cerebral perfusion group. The total Histopathologic Damage Score (0, normal; 32, worst) in the intermittent retrograde cerebral perfusion group (8.0 ± 0.6) was significantly lower than that in the conventional retrograde cerebral perfusion (17.5 ± 1.7; P < .01) and circulatory arrest (25 ± 1.0; P < 0.01) groups and was equivalent to that in the antegrade selective cerebral perfusion group (7.8 ± 0.8; P = .9).

Conclusion: Intermittent retrograde cerebral perfusion provides adequate neuroprotection by allowing high apparent diffusion coefficient values to be maintained.

Abbreviations and Acronyms ADC = apparent diffusion coefficient; ASCP = antegrade selective cerebral perfusion; CA = circulatory arrest; CPB = cardiopulmonary bypass; DHCA = deep hypothermic circulatory arrest; DWI = diffusion-weighted magnetic resonance imaging; HDS = Histopathologic Damage Score; MRI = magnetic resonance imaging; PWI = perfusion-weighted magnetic resonance imaging; RCP = retrograde cerebral perfusion; RCP-C = conventional retrograde cerebral perfusion; RCP-INT = retrograde cerebral perfusion with intermittent pressure augmentation; rrCBV = relative regional cerebral blood volume




This article has been cited by other articles:


Home page
 CirculationHome page
A. L. Estrera, C. C. Miller III, T.-Y. Lee, P. Shah, and H. J. Safi
Ascending and Transverse Aortic Arch Repair: The Impact of Retrograde Cerebral Perfusion
Circulation, September 30, 2008; 118(14_suppl_1): S160 - S166.
[Abstract] [Full Text] [PDF]


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
Copyright © 2006 by The American Association for Thoracic Surgery.