[HSF] cannula for selective cerebral perfusion

[Tohru Asai]

Dear Mark
Thank you for your inquiry. Our system has a separate roller pump for
cerebral perfusion, it is not a branch of main arterial perfusion line. In
the operative field, the line (size is the same to blood cardioplegia line)
is devided into three lines, with two "Y"s. Antegrade catheters are set up
for all three brachiocephalic vessels, with total flow rate 500 ml/min at 25
degree C. Left subclavian artery is always cannulated. Because of following
reasons.

1. The vertebro-basilar system is occasionally left dominant, or there may
be stenotic lesion in right vertebral artery.
2. Three slip-stopper ballooned catheters create surprisingly clean
bloodless field compared with DHCA and/or RCP. Even small venous injury near
the distal aortic stump.At least for me, the operative field look better
than the subclavian artery clamping.
3. The subclavian anastomosis is easy to construct with gentle traction of
the slip-stopper cath.

IMHO. Many forum members are American. They are more or less influenced
strongly by prominent surgeons like Dr.Griep, That is why they have been a
little hesitating to challenge other modalities (RCP, SCP).I understand
Ani's position for example.
I was trained in US, and learned a lot of benefits and techniques of
DHCA.Then I started up my practice here and adopted selective cerebral
perfusion from other Japanese surgeons.Compared to God fathers like Kazui,
Ohkita,, I am still like a baby, but developing surgeon. I like Dr. Bachet's
words, I also want to be an ordinary simple cardiac surgeon!
Best regards
-- 
Tohru Asai

 


> Do you have a manifold or splitter on your arterial line?
> How do you connect these cannula to your arterial circuit?