What is cerebral metabolism during retrograde perfusion?

Abstract

are excellent conduits and should be used if there is any question regarding adequate length.My second comment is in regard to the use of the electrocautery in the skeletonization technique of ITA dissection. In their article comparing the effects of monopolar and bipolar cauterization on skeletonized ITA's, Yoshida and associates 3 go into detail describing the damaging effects of the two cauterization techniques on these relatively fragile arteries. I suggest that the arteries would sustain far less damage and hemostasis would be immediate and secure if hemoclips, rather than cautery, are used on the ITA branches. As described in our article, 2 thermal trauma to the ITA is thus specifically avoided. If meticulous clip application techniques are used and scrupulous attention is paid to the details of the dissection, fewer than 1% of skeletonized ITAs are unsuitable conduits.One of the main advantages to the use of arterial conduits is their longevity. I therefore propose that conduit life will remain optimum if we do our best to use harvesting techniques that keep arterial wall and intimal trauma to an absolute minimum.

Regional Tissue Blood Flow and pH in the Brain during Deep Hypothermic Retrograde Brain Perfusion

“…The hydrogen clearance method [19][20][21] measures the ability to diffuse hydrogen gas in the tissue as cerebral blood flow (CBF). There, the CBF value includes increased nonfunctional shunt blood flow in the brain surface venous network during retrograde perfusion [17]. Laser flowmetry provides continuous monitoring that enables probe positioning to exclude nonfunctioning shunt flow in the large veins [16,17].…”

“…There, the CBF value includes increased nonfunctional shunt blood flow in the brain surface venous network during retrograde perfusion [17]. Laser flowmetry provides continuous monitoring that enables probe positioning to exclude nonfunctioning shunt flow in the large veins [16,17]. The microsphere method [13, 21,24] shows the distribution and the functional quantity of nutrient blood flow through the capillary bed in the brain when an adequate size is selected.…”

“…Their model may also be affected by venous valves competent in pigs and shunt escape flow, since they perfused the brain through the SVC without brain is not perfused [13,17]. This experimental situatreating the azygos vein.…”

“…Regional brain pH was mapped photometri-structed the experimental approach to define optimal cally using neutral red as a pH-indicating dye after 90 conditions for this perfusion. There have been no sub- SVC perfusion [15][16][17]. In the present study, we exam- Key Words: retrograde brain perfusion; deep hypoAnimal preparation and cardiopulmonary bypass (CPB).…”

Retrograde cerebral perfusion: experimental approach to brain oedema

“…However, it remains unclear whether it replicates well-conducted retrograde cerebral perfusion in human beings, 2,3 because extracranial venous perfusion may not provide nutrient blood flow at all to the animal brain tissue even when blood flow is observed in the brain surface; that may show venovenous shunt flow. [16][17][18][19] Competent venous valves in the animal head and neck block the perfused blood from reaching the brain. The animal brain is small and wrapped in a large venous network that shunts the perfused blood away from the brain.…”