Original articleAdult cardiacCerebral Circulation During Retrograde Cerebral Perfusion: Evaluation Using Laser Speckle Flowgraphy
Section snippets
Study Design
This was a single-center, prospective, observational study. The study protocol was approved by the Asahikawa Medical University Research Ethics Committee (approval number: 15102) and was registered as a clinical trial (UMIN000034259). Written informed consent was obtained from all patients.
Inclusion Criteria
Consecutive patients who underwent scheduled aortic arch repair for aneurysm were enrolled. The candidates were screened for eligibility for participation in the study through preoperative assessment.
Study Population and Surgical Outcome
Table 1 shows a summary of the patients’ backgrounds. A total of 28 consecutive patients were enrolled. Preoperative magnetic resonance imaging and computed tomographic scans indicated atherosclerotic lesions in the internal carotid artery in 3 patients. One patient had change of operative procedure or SCP methods. As a result, 23 patients were analyzed. Twelve and 11 patients underwent total arch replacement and hemiarch replacement, respectively. The 30-day mortality rate was 0%; 1 patient
Comment
To the best of our knowledge, this is the first study to estimate ONH blood flow during RCP in thoracic aorta surgery using LSFG to monitor the cerebral circulation. The results of our study demonstrated that the cerebral microcirculation during RCP detected by LSFG was similar to moderate HCA without adjunctive strategy. Moreover, the cerebral microcirculation during SCP was significantly higher compared with simple circulatory arrest and RCP under moderate hypothermia.
A retrospective
References (25)
- et al.
Neurologic outcome after ascending aorta-aortic arch operations: effect of brain protection technique in high-risk patients
J Thorac Cardiovasc Surg
(2001) - et al.
Temporary neurological dysfunction after deep hypothermic circulatory arrest: a clinical marker of long-term functional deficit
Ann Thorac Surg
(1999) Cerebral protection during aortic arch surgery
J Thorac Cardiovasc Surg
(2001)- et al.
Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion combined with deep hypothermia circulatory arrest in aortic arch surgery: a meta-analysis and systematic review of 5060 patients
J Thorac Cardiovasc Surg
(2014) - et al.
A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without retrograde cerebral perfusion: analysis based on the Japan Adult Cardiovascular Surgery Database
J Thorac Cardiovasc Surg
(2015) - et al.
Comparative study of retrograde and selective cerebral perfusion with transcranial Doppler
Ann Thorac Surg
(1999) - et al.
Retrograde cerebral perfusion provides negligible flow through brain capillaries in the pig
J Thorac Cardiovasc Surg
(2001) - et al.
Ocular blood flow measured using laser speckle flowgraphy during aortic arch surgery with antegrade selective cerebral perfusion
J Cardiothorac Vasc Anesth
(2016) - et al.
Non-contact, two-dimensional measurement of tissue circulation in choroid and optic nerve head using laser speckle phenomenon
Exp Eye Res
(1995) - et al.
Mortality and cerebral outcome in patients who underwent aortic arch operations using deep hypothermic circulatory arrest with retrograde cerebral perfusion: no relation of early death, stroke, and delirium to the duration of circulatory arrest
J Thorac Cardiovasc Surg
(1998)