[A clinical study of retrograde cerebral perfusion in long duration].
The safety limit of retrograde cerebral perfusion (RCP) in aortic arch reconstruction was evaluated in comparison with long (> or = 60 min: group A = 28 cases) and short (< 60 min: group B = 88 cases) RCP time (RCPT). RCPT was 60-94 min in group A and 24-59 min in group B. Hospital mortality was 7.1% and 6.8% in group A and B, respectively. There was no case who was died due to cerebral insufficiency. Postoperative neurological complication was observed 3 in group A and 3 in group B. There was no significance between 2 groups. There were no significant differences in the time to awake, ICU stay, electroencephalogram, and cognitive functions between 2 groups. Based on these results, the safety limit of RCP is over than 60 min and, maybe, about 90 min. We monitored the increase of deoxygenated hemoglobin (HbR) during RCP using a near infrared spectroscopy (n = 55). Since HbR increased gradually during RCP, HbR reflects oxygen metabolism non-invasively in the brain. HbR can be one of useful indexes of the brain protection during RCP.
Yoshitaka
H
H
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Takamoto
S
S
Okita
Y
Y
Ando
M
M
Morota
T
T
Yamaki
H
H
D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010477:Perfusion; D013997:Time Factors