Regional High-Flow Cerebral Perfusion Improves Both Cerebral and Somatic Tissue Oxygenation in Aortic Arch Repair

2010 ◽  
Vol 90 (2) ◽  
pp. 593-599 ◽  
Author(s):  
Kagami Miyaji ◽  
Takashi Miyamoto ◽  
Satoshi Kohira ◽  
Kei-ichi Itatani ◽  
Takahiro Tomoyasu ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Tissue Oxygenation ◽  
Somatic Tissue ◽  
High Flow ◽  
Aortic Arch Repair

scholarly journals Markers of peripheral perfusion during high-flow regional cerebral perfusion for aortic arch repair

2018 ◽  
Vol 156 (6) ◽  
pp. 2251-2257 ◽  
Author(s):  
Koichi Sughimoto ◽  
Satoshi Kohira ◽  
Hidenori Hayashi ◽  
Shinzo Torii ◽  
Tadashi Kitamura ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Cerebral Perfusion ◽  
High Flow ◽  
Peripheral Perfusion ◽  
Aortic Arch Repair

scholarly journals The effect of selective cerebral perfusion on cerebral versus somatic tissue oxygenation during aortic coarctation repair in neonates and infants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Zhang ◽  
Lu Liu ◽  
Zhiqiu Zhong ◽  
Hengfang Jin ◽  
Jian Jia ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Cerebral Perfusion ◽  
Tissue Oxygenation ◽  
Perioperative Complications ◽  
Somatic Tissue ◽  
Tissue Oxygen Saturation ◽  
Selective Cerebral Perfusion ◽  
Arterial Blood ◽  
Coarctation Repair ◽  
Neonates And Infants

Abstract Background Suboptimal tissue perfusion and oxygenation may be the root cause of certain perioperative complications in neonates and infants having complicated aortic coarctation repair. Practical, effective, and real-time monitoring of organ perfusion and/or tissue oxygenation may provide early warning of end-organ mal-perfusion. Methods Neonates/infants who were scheduled for aortic coarctation repair with cardiopulmonary bypass (CPB) and selective cerebral perfusion (SCP) from January 2015 to February 2017 in Children’s Hospital of Nanjing Medical University participated in this prospective observational study. Cerebral and somatic tissue oxygen saturation (SctO2 and SstO2) were monitored on the forehead and at the thoracolumbar paraspinal region, respectively. SctO2 and SstO2 were recorded at different time points (baseline, skin incision, CPB start, SCP start, SCP end, aortic opening, CPB end, and surgery end). SctO2 and SstO2 were correlated with mean arterial pressure (MAP) and partial pressure of arterial blood carbon dioxide (PaCO2). Results Data of 21 patients were analyzed (age=75±67 days, body weight=4.4±1.0 kg). SstO2 was significantly lower than SctO2 before aortic opening and significantly higher than SctO2 after aortic opening. SstO2 correlated with leg MAP when the measurements during SCP were (r=0.67, p<0.0001) and were not included (r=0.46, p<0.0001); in contrast, SctO2 correlated with arm MAP only when the measurements during SCP were excluded (r=0.14, p=0.08 vs. r=0.66, p<0.0001). SCP also confounded SctO2/SstO2’s correlation with PaCO2; when the measurements during SCP were excluded, SctO2 positively correlated with PaCO2 (r=0.65, p<0.0001), while SstO2 negatively correlated with PaCO2 (r=-0.53, p<0.0001). Conclusions SctO2 and SstO2 have distinct patterns of changes before and after aortic opening during neonate/infant aortic coarctation repair. SctO2/SstO2’s correlations with MAP and PaCO2 are confounded by SCP. The outcome impact of combined SctO2/SstO2 monitoring remains to be studied.

Mid-Long-Term Results After Aortic Arch Repair Using a Four-Branched Graft With Antegrade Selective Cerebral Perfusion

2013 ◽  
Vol 28 (5) ◽  
pp. 537-542 ◽  
Author(s):  
Satoshi Numata ◽  
Yasushi Tsutsumi ◽  
Osamu Monta ◽  
Sachiko Yamazaki ◽  
Hiroyuki Seo ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Long Term Results ◽  
Selective Cerebral Perfusion ◽  
Aortic Arch Repair ◽  
Branched Graft ◽  
Antegrade Selective Cerebral Perfusion

Retrograde cerebral perfusion: overview, techniques and results

Perfusion ◽  
1995 ◽  
Vol 10 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Steven A Raskin ◽  
Joseph S Coselli
Keyword(s):  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Clinical Results ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Retrograde Cerebral Perfusion ◽  
Profound Hypothermia ◽  
Neurological Morbidity ◽  
Aortic Arch Repair

Cardiovascular surgical repair of arch aneurysms is taking a step forward by going backwards by utilizing retrograde cerebral perfusion. Drs ME DeBakey, ES Crawford, DA Cooley and GC Morris first reported successful resection and repair of a fusiform aneurysm of the aortic arch with replacement graft in 1957.1 Since then, Crawford and Coselli have pursued materials and techniques which have made this procedure, one which generally resulted in high morbidity and mortality, more viable with decreased morbidity and mortality. Increased numbers of patients are now having this repair and are resuming normal healthy lives after the operation. From February 1992 to October 1993, 88 patients were surgically treated by Coselli who utilized retrograde cerebral perfusion with profound hypothermia and circulatory arrest, thus allowing for repairs that under any other conditions probably could not have been achieved successfully. It is evident that a major determinant for the successful clinical results, in addition to surgical technique and skill, was the employment of profound hypothermia and circulatory arrest. This article will review the techniques and results of aortic arch repair utilizing retrograde cerebral perfusion during circulatory arrest with profound hypothermia to lessen the chance of neurological morbidity following surgical replacement of the transverse aortic arch.

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