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Directly visualized cerebral circulation during retrograde cerebral perfusion

N Yoshimura¹, K Ataka, M Okada

¹Department of Surgery, Kobe University School of Medicine, Japan.

The Journal of Cardiovascular Surgery

|December 1, 1996

Summary

Retrograde cerebral perfusion (RCP) during thoracic aorta surgery reduces brain blood flow, evidenced by retinal artery constriction. This suggests RCP may not sufficiently support brain metabolism despite its protective role.

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Area of Science:

Cardiovascular Surgery
Neurology
Ophthalmology

Background:

Retrograde cerebral perfusion (RCP) is used to protect the brain during thoracic aorta operations.
The adequacy of brain blood supply during RCP is not well understood.

Purpose of the Study:

To evaluate cerebral circulation during RCP by observing the optic fundus.
To assess the effectiveness of RCP in maintaining adequate brain blood flow.

Main Methods:

Ophthalmoscopic examination of patients undergoing thoracic aorta surgery with RCP.
Observation of retinal artery and vein diameters during the procedure.
Data collected from 4 patients (1 male, 3 female, ages 34-78) with RCP times of 39-70 minutes.

Main Results:

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Retinal arteries showed significant constriction shortly after RCP initiation.
Retinal veins maintained near-normal diameter.
Large retinal arteries became thread-like, and smaller arteries were not visible within 30 minutes of RCP.

Conclusions:

Ophthalmoscopic findings indicate reduced cerebral blood flow, particularly arterial flow, during RCP.
While beneficial for brain protection, RCP alone may not provide sufficient blood supply for optimal cerebral metabolism.