Okamoto H, Sato H, Morita S, Matsuura A, Tasuura K, Ogawa Y, Sawazaki Y, Hoshino M, Asakura T, Seki A
Division of Thoracic Surgery, Yokkaichi Municipal Hospital, Japan.
Kyobu Geka. 1993 Jul;46(8 Suppl):677-81.
46 patients underwent surgery for the ascending aorta and the aortic arch using continuous hypothermic retrograde systemic venous perfusion (RSVP). Good cerebral protection has been obtained by this method in most patients including four in whom periods of retrograde perfusion exceeded 90 minutes (the longest 140 min). In first 19 patients retrograde perfusion was performed through conventional caval cannulae, but one of them sustained serious neurological damage despite a relatively short duration of retrograde perfusion probably due to impediment of retrograde flow to the brain with venous valves at the jugular-subclavian junction. Then we have developed a new technique that employs a cavoatrial cannula inserted selectively into the internal jugular vein beyond the valve at the venous angle and have applied this technique in last 27 patients.
46例患者采用持续低温逆行性体静脉灌注（RSVP）进行升主动脉和主动脉弓手术。通过这种方法，大多数患者都获得了良好的脑保护，其中包括4例逆行灌注时间超过90分钟（最长140分钟）的患者。在最初的19例患者中，逆行灌注是通过传统的腔静脉插管进行的，但其中1例尽管逆行灌注时间相对较短，仍遭受了严重的神经损伤，这可能是由于颈静脉-锁骨下静脉交界处的静脉瓣膜阻碍了逆行血流至脑部。随后，我们开发了一种新技术，即选择性地将腔房插管插入颈内静脉，越过静脉角处的瓣膜，并将该技术应用于最后27例患者。
