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Ann Thorac Surg 2002;73:2038
© 2002 The Society of Thoracic Surgeons

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Correspondence

Retrograde cerebral perfusion

^a Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India

e-mail: anilbhan{at}hotmail.com

To the Editor

The case report by Bridges and colleagues [1] is interesting and the authors have described the use of left superior vena cava for retrograde cerebral perfusion.

Earlier, we published a letter to the editor in The Annals of Thoracic Surgery [2]. In this particular patient, we used the left superior vena cava for retrograde cerebral perfusion in a patient with distal arch aneurysm. We wish the authors had acknowledged that communication.

We have started using the left internal jugular vein for retrograde cerebral perfusion (RCP) in patients with distal arch aneurysm and those with thoraco-abdominal aortic aneurysm which require total circulatory arrest. We expose the left internal jugular vein in the neck and cannulate it with No. 20 RMI venous cannula (catalogue No. TF020L90) and snug it. We use it forvenous drainage during cardiopulmonary bypass, and the same cannula is used for RCP during hypothermic circulatory arrest. Although we do not have documented EEG and SEP recordings, we have not encountered any neurological deficit of any magnitude in any of 5 patients in whom we have used this technique. In addition to providing cold, oxygenated blood to the brain, the method provides an opportunity to completely de-air the arch and to wash away debris from the arch vessels and arch before restarting arterial inflow. We intend to do EEG studies of the two cerebral hemispheres to see the pattern of protection offered by this technique.

References

1. Bridges C.R., Gorman R.C., Stecher M.M., Bararía J.E. Acute type A aortic dissection: retrograde perfusion with left superior vena cava. Ann Thorac Surg 2000;69:1940-1941.[Abstract/Free Full Text]
2. Bhan A., Choudhary S.K., Sharma R., Venugopal P. Left superior vena cava in a distal arch aneurysm, could it be of any advantage?. Ann Thorac Surg 1999;68:294.[Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Anil Bhan Panangipalli Venugopal Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bhan, A. Articles by Venugopal, P. Search for Related Content PubMed PubMed Citation Articles by Bhan, A. Articles by Venugopal, P.