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A novel protocol of retrograde cerebral perfusion with intermittent pressure augmentation for brain protection  Kazuo Kitahori, MD, Shinichi Takamoto,

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Presentation on theme: "A novel protocol of retrograde cerebral perfusion with intermittent pressure augmentation for brain protection  Kazuo Kitahori, MD, Shinichi Takamoto,"— Presentation transcript:

1 A novel protocol of retrograde cerebral perfusion with intermittent pressure augmentation for brain protection  Kazuo Kitahori, MD, Shinichi Takamoto, MD, PhD, Hiroo Takayama, MD, Yoshihiro Suematsu, MD, PhD, Minoru Ono, MD, PhD, Noboru Motomura, MD, PhD, Teturo Morota, MD, PhD, Kengo Takeuchi, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 130, Issue 2, Pages (August 2005) DOI: /j.jtcvs Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Comparison of the recovery scores postoperatively in each group. CA, Circulatory arrest; c-RCP, conventional retrograde cerebral perfusion; int-RCP, intermittent retrograde cerebral perfusion. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Retina in the intermittent retrograde cerebral perfusion (int-RCP) group. The failure of the retinal vessels to open at an RCP pressure of 25 mm Hg (a-d). The same pressure effectively opened the retinal vessels (e-h). Before cardiopulmonary bypass (CPB) (a, e); at 15 mm Hg of RCP (b, f); at 25 mm Hg of RCP (c, g); at 45 mm Hg of RCP (d, h). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Values for the retinal arteries and veins are shown as a percentage of the control. The diameter of the retinal veins was smaller at an RCP pressure of 15 mm Hg than in controls or animals in which an RCP pressure of 45 mm Hg was used; control, before CPB; 15 mm Hg, RCP pressure of 15 mm Hg; 25 mm Hg, RCP pressure of 25 mm Hg; 45 mm Hg, RCP pressure of 45 mm Hg. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Concentration of Tau proteins in the CSF measured 12 hours after the operation. CSF, Cerebrospinal fluid; CA, circulatory arrest; c-RCP, conventional retrograde cerebral perfusion; int-RCP, intermittent retrograde cerebral perfusion. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

6 Figure 5 Histopathologic scores for the investigated regions of the brain in each group. The scores of the int-RCP group were significantly better than in either of the other 2 groups, particularly in the hippocampus region. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

7 Figure 6 Histopathologic changes in the hippocampus region of the CA group. A, Degeneration of neurons. B, Nuclear chromatin condensation and shrinkage of neurons. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions


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