ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Ann Thorac Surg 2010;90:593-599. doi:10.1016/j.athoracsur.2010.03.113
© 2010 The Society of Thoracic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Kagami Miyaji
Takashi Miyamoto
Kuniyoshi Ohara
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Miyaji, K.
Right arrow Articles by Ohara, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Miyaji, K.
Right arrow Articles by Ohara, K.
Related Collections
Right arrow Congenital - acyanotic

Original Articles: Pediatric Cardiac

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

Kagami Miyaji, MD, PhD*, Takashi Miyamoto, MD, PhD, Satoshi Kohira, CCP, Kei-ichi Itatani, MD, Takahiro Tomoyasu, MD, Nobuyuki Inoue, MD, Kuniyoshi Ohara, MD, PhD

Department of Cardiovascular Surgery, Kitasato University, School of Medicine, Sagamihara, Japan

Accepted for publication March 26, 2010.

* Address correspondence to Dr Miyaji, Department of Cardiovascular Surgery, Kitasato University, School of Medicine, Kitasato 1-15-1, Sagamihara 228-8555, Japan (Email: kagami111{at}aol.com).

Presented at the Forty-sixth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 25–27, 2010.

Background: Regional cerebral perfusion provides cerebral circulatory support during aortic arch reconstruction. We report the effectiveness of high-flow regional cerebral perfusion (HFRCP) from the right innominate artery to maintain sufficient cerebral and somatic oxygen delivery through collateral vessels.

Methods: Frontal cerebral and thoracolumbar probes to measure somatic regional oxygen saturation (rSO 2) were used to continuously measure oxygenation during cardiopulmonary bypass in 18 patients (weight, 2.1 to 4.3 kg) who underwent arch reconstruction using HFRCP (mean flow, 82; range, 43 to 108 ml/kg/min). Procedures included 9 Norwood procedures, 5 coarctation of aorta/interruption of aorta complex repairs, and 4 aortic arch repairs for a single ventricle. Mean HFRCP duration was 51 ± 17 minutes under moderate hypothermia. Mean radial arterial pressure was kept at less than 50 mm Hg during HFRCP, and chlorpromazine (mean dose, 2.8 mg/kg) was given to all patients before and during HFRCP to increase regional cerebral perfusion flow. Plasma lactate concentration was measured before and after HFRCP.

Results: During HFRCP, mean cerebral rSO 2 was 78.8% ± 9.5%, somatic rSO 2 was 65.4% ± 12.1%, and lactate concentration increased from 3.8 ± 2.2 to 5.5 ± 2.1 mmol/L. There was significant correlation between regional cerebral perfusion flow and somatic rSO 2. Significant inverse correlations were noted between regional cerebral perfusion flow and the increase of lactate concentration and between somatic rSO 2 and the increase of lactate concentration.

Conclusions: High-flow regional cerebral perfusion preserved sufficient cerebral and somatic tissue oxygenation during aortic arch repair. The reduction of vascular resistance of collateral vessels increased both cerebral and somatic blood flow, resulting in improved tissue oxygen delivery.




This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. O. Algra, A. N. J. Schouten, W. van Oeveren, I. van der Tweel, P. H. Schoof, N. J. G. Jansen, and F. Haas
Low-flow antegrade cerebral perfusion attenuates early renal and intestinal injury during neonatal aortic arch reconstruction
J. Thorac. Cardiovasc. Surg., December 1, 2012; 144(6): 1323 - 1328.e2.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. O. Algra, V. N. N. Kornmann, I. van der Tweel, A. N. J. Schouten, N. J. G. Jansen, and F. Haas
Increasing duration of circulatory arrest, but not antegrade cerebral perfusion, prolongs postoperative recovery after neonatal cardiac surgery
J. Thorac. Cardiovasc. Surg., February 1, 2012; 143(2): 375 - 382.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Cardiothorac SurgHome page
K. Miyaji, T. Miyamoto, S. Kohira, T. Yoshii, K.-i. Itatani, H. Sato, and N. Inoue
The effectiveness of high-flow regional cerebral perfusion in Norwood stage I palliation
Eur J Cardiothorac Surg, November 1, 2011; 40(5): 1215 - 1220.
[Abstract] [Full Text] [PDF]

Home page
 Interact CardioVasc Thorac SurgHome page
K. Takeuchi, A. Masuzawa, J. Kobayashi, and K. Tsuchiya
Neonatal repair of right interrupted aortic arch with cerebro-myocardial perfusion technique
Interact CardioVasc Thorac Surg, October 1, 2011; 13(4): 427 - 428.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. Liu, B. Ji, C. Long, F. Yan, J. Yan, and S. Li
Is Regional High-Flow Perfusion Safe for Cerebral Function in Pediatric Patients During Deep Hyperthermia?
Ann. Thorac. Surg., May 1, 2011; 91(5): 1650 - 1651.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2010 by The Society of Thoracic Surgeons.