Flow velocity of central retinal artery and retrobulbar vessels during cardiovascular operations.
Flow velocity of central retinal artery and retrobulbar vessels during cardiovascular operations.
复制标题
心血管手术中视网膜中央动脉和球后血管的流速。
DOI：
10.1016/s0022-5223(97)70023-0
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
K. Okada
中科院分区：
文献类型：
--
作者：
K. Orihashi;Y. Matsuura;T. Sueda;H. Shikata;S. Morita;S. Hirai;M. Sueshiro;K. Okada
心血管手术中，血流监测和压力监测都是必要的，以避免脑灌注不足。由于经颅多普勒超声检查不提供一贯良好的信号，特别是在心肺转流，我们检查了通过视网膜中央动脉，这已被证明是反映阻塞的颈动脉。Method 28个连续的情况下进行了检查与5或7.5 MHz的常规超声心动图探头的血流。研究视网膜中央动脉最大血流速度与收缩压的相关性。在选择性或逆行性脑灌注或主动脉内球囊反搏过程中检查视网膜中央动脉和球后血管的血流。478个测点的收缩压与最大血流速度相关（r = 0.6902，p < 0.0001）。血压轴截距，称为“临界闭合压”，为35.8 ± 14.8 mm Hg，个体和双眼之间存在差异。体外循环后搏动指数增加（1.095 ± 0.245至1.525 ± 0.268，p < 0.0001）。Willis环的通畅性通过吻合同侧动脉时的血流来证实。在逆行脑灌注过程中，可检测到球后血管的血流。在主动脉内球囊泵，视网膜中央动脉流量增加膨胀的balloon.ConclusionOrbital血管监测提供了视网膜中央动脉的临界关闭压力，并确认通畅的Willis环。在心血管手术中，眼睛可以是颅内血流的“声窗”。（《胸血管外科杂志》1997;114：1081-7）
ObjectiveBoth blood flow monitoring and pressure monitoring are necessary to avoid inadequate cerebral perfusion during cardiovascular operations. Inasmuch as transcranial Doppler ultrasonography does not provide a consistently good signal, especially during cardiopulmonary bypass, we examined the blood flow through the central retinal artery, which has proved to reflect an obstruction of the carotid artery.MethodTwenty-eight consecutive cases were examined with a 5 or 7.5 MHz conventional echocardiographic probe. Correlation between the maximal velocity at the central retinal artery and systolic blood pressure was examined. The blood flow of the central retinal artery and retrobulbar vessels was examined during selective or retrograde cerebral perfusion or intraaortic balloon pumping.ResultsBlood flow could be clearly visualized but disappeared below a certain pressure in every case. With data from 478 measuring points, systolic blood pressure correlated with maximal velocity ( r = 0.6902, p < 0.0001). The blood pressure–axis intercept, known as “critical closing pressure,” was 35.8 ± 14.8 mm Hg, varying among individuals and bilateral eyes. Pulsatility index increased after cardiopulmonary bypass (1.095 ± 0.245 to 1.525 ± 0.268, p < 0.0001). Patency of the circle of Willis was confirmed by the blood flow during anastomosis of the ipsilateral artery. During retrograde cerebral perfusion, blood flow was detectable at the retrobulbar vessels. During intraaortic balloon pumping, the central retinal artery flow was augmented on inflation of the balloon.ConclusionOrbital vessel monitoring provides the critical closing pressure of the central retinal artery and confirms patency of the circle of Willis. The eye can be “an acoustic window” into intracranial blood flow during cardiovascular surgery. (J Thorac Cardiovasc Surg 1997;114:1081-7)