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Ann Thorac Surg 1999;67:1096
© 1999 The Society of Thoracic Surgeons

Invited Commentary

Julie A. Swain, MDa

a Division of Cardiothoracic and Vascular Surgery, University of Kentucky College of Medicine, 800 Rose St, MN 276, Lexington, KY, 40536-0084, USA

e-mail: Jswain{at}pop.uky.edu

Invited commentary

The quest for a way to reliably determine the safe duration of circulatory arrest continues. The study by Higami and associates is a clinical study supporting the use of cerebral oxygen saturation measurements as one method of monitoring the status of the brain during circulatory arrest. The most important contribution this study makes is to provide clinical data corroborating previous animal studies showing the lack of efficacy of retrograde cerebral perfusion in providing oxygen to the brain. Many clinical reports of retrospective studies that lacked careful neurologic assessment have touted the benefits of retrograde perfusion. As yet, no carefully performed prospective clinical study of the benefits of retrograde perfusion has been published. Despite the laboratory and clinical studies that do not show benefit, retrograde perfusion might have a role as an adjunct for neuroprotection by flushing out potential air and particulate emboli from the arch vessels.


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Retrograde cerebral perfusion versus selective cerebral perfusion as evaluated by cerebral oxygen saturation during aortic arch reconstruction
Tetsuya Higami, Syuichi Kozawa, Tatsuro Asada, Hidefumi Obo, Kunio Gan, Kazuhiko Iwahashi, and Hideaki Nohara
Ann. Thorac. Surg. 1999 67: 1091-1096. [Abstract] [Full Text] [PDF]




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