Selective jugular cannulation of safer retrograde cerebral perfusion

Hypothermic retrograde cerebral perfusion is a new technique for protecting the brain. Satisfactory cerebral protection should be possible even for periods of retrograde perfusion greater than 60 minutes. However, there are some concerns that functioning venous valves at the jugular-subclavian junction may impede retrograde flow to the brain and consequently cerebral protection may not be adequate. To overcome this obstacle, we have developed an easy and safe technique of selective jugular cannulation through the right atrium using a central venous catheter and a guidewire. We have employed this technique successfully in 15 patients who underwent operation on the aortic arch.