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Ann Thorac Surg 1993;55:538-540
© 1993 The Society of Thoracic Surgeons

Articles

Selective jugular cannulation for safer retrograde cerebral perfusion

Hiroshi Okamoto, MD*, Kosei Sato, MD, Akio Matsuura, MD, Yutaka Ogawa, MD, Teiji Asakura, MD, Motoaki Hoshino, MD, Akira Seki, MD, Toshio Abe, MD, Kenzo Yasuura, MD

Division of Thoracic Surgery, Yokkaichi Municipal Hospital, and Department of Thoracic Surgery, Nagoya University School of Medicine, Yokkaichi, Japan

Accepted for publication October 23, 1992.

* Address reprint requests to Dr Okamoto, Division of Thoracic Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan, Shibata-2-22-37, Yokkaichi, Japan.

Hypothermic retrograde cerebral perfusion is a new technique for protecting the brain. Satisfactory cerebral protection should be possible even for periods of retrograde perfusion greater than 60 minutes. However, there are some concerns that functioning venous valves at the jugular-subclavian junction may impede retrograde flow to the brain and consequently cerebral protection may not be adequate. To overcome this obstacle, we have developed an easy and safe technique of selective jugular cannulation through the right atrium using a central venous catheter and a guidewire. We have employed this technique successfully in 15 patients who underwent operation on the aortic arch.




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