Abstract
A new catheter for retrograde cerebral perfusion (RCP), which can (1) deliver blood directly into the internal jugular vein (IJV) even in a case with the competent venous valves at the jugular subclavian junction, (2) prevent blood from draining into the lower half of the body, and (3) allow aortic arch replacement via median sternatomy as well as lateral thoracotomy, was developed. This catheter can be inserted into the W via a standard puncture technique. A balloon for occlusion of superior vena cava (SVC) is installed at thee catheter tip. Side holes, through which blood is delivered into the UV, are located 95 mm from the catheter tip. RCP by use of this catheter was performed in seven cases of aortic arch replacement. Venography showed that the inflated balloon successfully occluded SVC, and contrast media preferentially flowed from IJV into the head. The mean flow rate was 327 mL/min for maintenance of the pressure of the UV pressure at around 20 mmHg. Since all procedures were controlled from outside of the operative field, RCP by use of this catheter could be useful in distal arch replacement via left lateral thoracotomy.
