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Total Arch Replacement Under Flow Monitoring During Selective Cerebral Perfusion Using a Single Pump  Hideyuki Shimizu, MD, PhD, Toru Matayoshi, CP, Masanori.

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Presentation on theme: "Total Arch Replacement Under Flow Monitoring During Selective Cerebral Perfusion Using a Single Pump  Hideyuki Shimizu, MD, PhD, Toru Matayoshi, CP, Masanori."— Presentation transcript:

1 Total Arch Replacement Under Flow Monitoring During Selective Cerebral Perfusion Using a Single Pump 
Hideyuki Shimizu, MD, PhD, Toru Matayoshi, CP, Masanori Morita, CP, Toshihiko Ueda, MD, PhD, Ryohei Yozu, MD, PhD  The Annals of Thoracic Surgery  Volume 95, Issue 1, Pages (January 2013) DOI: /j.athoracsur Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Selective antegrade cerebral perfusion. (A) Schema. (B) Photographed image. All three supraaortic vessels were cannulated by means of balloon-tipped cannulas positioned from their openings through the incised aorta and perfused using a single pump. Flow distribution was passively determined depending on the vascular resistance of each vessel. Ultrasound Doppler flowmeters (F1, F2, F3) were installed in the circuit next to balloon-tipped perfusion cannulas, and flow rates of supraaortic vessels were continuously measured in real time. Flowmeters were positioned cephalad to the operative field and did not affect maneuverability. The Annals of Thoracic Surgery  , 29-34DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Rectal temperature during selective cerebral perfusion (SCP). Rectal temperatures (RT) at the start of hypothermic circulatory arrest, 30 minutes later, at resumption of systemic perfusion, and termination of selective cerebral perfusion were 25.8° ± 2.7°C, 25.4° ± 2.4°C, 25.3° ± 2.0°C, and 26.1° ± 1.9°C, respectively. Body temperature was maintained at a low level until selective cerebral perfusion was terminated. The Annals of Thoracic Surgery  , 29-34DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Flow rate of supraaortic vessels during selective cerebral perfusion. (A) Brachiocephalic artery (BCA). (B) Left common carotid artery (LCCA). (C) Left subclavian artery (LSCA). Flow in each supraaortic vessel was parallel to total flow of all three vessels. Relationships between flow in BCA, LCCA, and LSCA and total flow in supraaortic vessels are described by regression equations as given in the text. The Annals of Thoracic Surgery  , 29-34DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Proportion of flow in supraaortic vessels versus total flow. (A) Brachiocephalic artery (BCA). (B) Left common carotid artery (LCCA). (C) Left subclavian artery (LSCA). Total flow rate did not affect the proportion of flow in each supraaortic vessel. The Annals of Thoracic Surgery  , 29-34DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

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