Yoshimura N, Ataka K, Okada M, Yamashita C, Yoshimura K, Kobayashi S
Department of Surgery, Kobe University School of Medicine, Japan.
J Cardiovasc Surg (Torino). 1996 Dec;37(6):553-6.
Retrograde cerebral perfusion (RCP) was clinically introduced as a supportive technique to protect the brain during operations on the thoracic aorta. However, it remains unclear whether this procedure provides adequate blood supply for the brain.
We have observed the optic fundus of patients undergoing operation on the thoracic aorta to evaluate the cerebral circulation during RCP. There were 1 male and 3 female patients, ages ranged from 34 to 78 years. RCP time ranged from 39 to 70 minutes, and blood flow via the superior vena cava cannula ranged from 200 to 400 ml/min.
The arteries of the retina showed marked constrictions soon after the initiation of RCP. The veins showed almost normal diameter. The large arteries were reduced to thin threads, while the smaller arteries were invisible at 30 minutes after the initiation of retrograde cerebral perfusion.
Ophthalmoscopic findings demonstrate the reduction of cerebral blood flow, especially in arteries, during RCP. Although RCP is a useful technique for cerebral protection, it could be mentioned that the blood supply to the brain by RCP is not enough to maintain good cerebral metabolism.
逆行脑灌注（RCP）作为一种在胸主动脉手术中保护大脑的支持技术被临床应用。然而，该操作是否能为大脑提供充足的血液供应仍不清楚。
我们观察了接受胸主动脉手术患者的眼底，以评估逆行脑灌注期间的脑循环。患者有1名男性和3名女性，年龄在34至78岁之间。逆行脑灌注时间为39至70分钟，经上腔静脉插管的血流量为200至400毫升/分钟。
逆行脑灌注开始后不久，视网膜动脉出现明显收缩。静脉直径几乎正常。大动脉变细如线，而在逆行脑灌注开始30分钟后，小动脉则不可见。
眼底镜检查结果表明，逆行脑灌注期间脑血流量减少，尤其是动脉血流。虽然逆行脑灌注是一种用于脑保护的有用技术，但可以提及的是，逆行脑灌注对大脑的血液供应不足以维持良好的脑代谢。
