Abstract
We have undertaken the experimental protocol of 120 minutes of RCP followed by antegrade reperfusion. Eighteen mongrel dogs were used. Animals were divided into three groups as follow: in group I, no treatment was received; in group II, mannitol (2g/kg) was administered; and in group III, nicaraven 1, 2-bis(nicotmamido)-propanwas administered (1mg/kg/min). Our experimental results suggested that brain edema developed during the reperfusion period after RCP, and mannitol or nicaraven might prevent it. During the period from January 1991 to July 1994, 21 patients underwent operations of the thoracic aorta with the use of deep hypothermic retrograde cerebral perfusion(RCP). Four patients died before the adequate assessment of their neurolgic function. One patient had a cerebral infarction probably due to the dissection of the left common carotid artery. The remaining 16 cases showed clear consciousness and had no serious neurologic complications postoperatively. Blood gas analysis of the returned blood sampled from branches of the aortic arch and the ophthalmosco is findings demonstrated the insufficiency of blood supply to the brain during RCP. The supply of oxygen by RCP was not enough to maintain sufficient cerebral metabolism. Therefore, pharmacological brain protection should be recommended to prevent neurological complications during and after RCP.
