Perfusion of brain and viscera using modified retrograde cerebral perfusion for aortic arch surgery

Abstract

Abstract Background: Retrograde cerebral perfusion provides a similar neuroprotective effect as antegrade cerebral perfusion during hypothermic circulatory arrest. Neither of them, however, provides blood flow for the abdominal viscera. Methods: Here we reported a modified retrograde cerebral perfusion by tethering both superior and inferior vena cava with bands around the cannula and clamping the distal ends of both superior and inferior vena caval drainage tubes. Modified retrograde cerebral perfusion (mRCP)was performed in 8 patients. Results: During mRCP, retrograde perfusion flow was maintained at 3.8±1.8 mL min-1 kg-1 to keep central venous pressure at 21±2 mm Hg. Removing the cross-clamp of the distal end of the inferior vena caval drainage tube, eliminated blood flow in the liver and kidney, while cerebral blood flow decreased from 21.5 to 16 cm/sec. Conclusions: It is suggested that this technique may increase cerebral blood flow, and provide a supplementary blood flow for the lower body during circulatory arrest.