Comparison between continuous cerebral perfusion via right subclavian artery and retrograde cerebral perfusion via superior vena cava during deep hypothermic circulatory arrest

摘要

To compare the protective effects to brain between continuous selective cerebral perfusion via right subclavian artery (RSA) and retrograde cerebral perfusion via superior vena cava (SVC) during deep hypothermic circulatory arrest (DHCA).Methods Thirty-six hybrid cats with both sexes were randomly divided into 6 groups (n=6 in each).Group 1:DHCA for 45 min with no cerebral perfusion; Group 2:DHCA for 45 min with retrograde perfusion via SVC;Group 3:DHCA for 45 min with perfusion via RSA;Group 4:DHCA for 90 min with no cerebral perfusion; Group 5:DHCA for 90 minwith retrograde perfusion via SVC;Group 6:DHCA for 90 min with perfusion via RSA.Ultrastructure of cerebral tissue,lactate content in venous return blood,ATP content in cerebral tissue and activity of nitric oxide synthetase (NOS) in cerebral cells were measured.Results At the same DHCA time,groups with RSA and SVC had milder hypoxia changes of brain ultrastructure than that of groups with no cerebral perfusion.The lactate content and activity of cerebral NOS in groups with RSA and SVC were significantly lower than those in the groups with no cerebral perfusion (P<0.05), and ATP content in cerebral tissue were significantly higher (P<0.05).There were no significant differences between SVC group and RSA group in all of the indexes after DHCA for 45 min.After DHCA for 90 min,the ATP content in cerebral tissue in RSA group (2.02±0.19) μmol/g was significantly higher than that in SVC group [(1.72±0.21) μmol/g,P<0.05].Conclusion For the profit of brain protection,perfusion via RSA is a better way than retrograde perfusion via SVC during long period of DHCA.2 refs,3 tabs.