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Hiroyuki Kamiya
Uwe Klima
Christian Hagl
Klaus Kallenbach
Axel Haverich
Matthias Karck
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Ann Thorac Surg 2006;81:519-521
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Cerebral Microembolization During Antegrade Selective Cerebral Perfusion

Hiroyuki Kamiya, MD a , * , Uwe Klima, MD a , Christian Hagl, MD a , Frank Logemann, MD b , Michael Winterhalter, MD b , Malakh L. Shrestha, MD a , Klaus Kallenbach, MD a , Nawid Khaladj, MD a , Axel Haverich, MD a , Matthias Karck, MD a

a Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
b Division of Anesthesiology, Hannover Medical School, Hannover, Germany

Accepted for publication July 22, 2005.

* Address correspondence to Dr Kamiya, Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany (Email: hkamiya88{at}yahoo.co.jp).

BACKGROUND: This study quantified the number of intraoperative microemboli in patients undergoing aortic arch surgery using selective cerebral perfusion (SCP) in comparison with those in patients undergoing ascending aortic replacement without circulatory arrest and SCP.

METHODS: A transcranial Doppler monitoring of the medial cerebral artery was performed in 15 patients undergoing proximal arch replacement with SCP (SCP group) and 15 patients undergoing replacement of the ascending aorta (control group).

RESULTS: There was no significant difference in the high-intensity transient signal counts between the SCP group and the control group at any phase. In the SCP group, 4.8% of microemboli occurred during cross-clamping, and only 0.6% occurred during SCP. In the control group, 4.6% occurred during cross-clamping. Most microemboli occurred after removing the cross-clamps in both groups; 92.2% in the SCP group and 92.1% in the control group.

CONCLUSIONS: The present study demonstrated that outbreak frequency of microemboli during SCP was very low, and thus implies that the risk of embolic event that may be caused by SCP is very low.




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