Fundus microvascular flow monitoring during retrograde cerebral perfusion: an experimental study

Background. Retrograde cerebral perfusion (RCP) through the superior vena cava was clinically introduced as a supportive technique to protect the brain during deep hypothermic circulatory arrest. This study searched for a direct monitor of cerebral blood flow to evaluate the effect of cerebral perfusion. Methods. Retinal microvascular perfusions were studied in six piglets using fundus fluorescein angiography (FFA) and color Doppler sonography before cardiopulmonary bypass and retrograde cerebral perfusion during deep hypothermic circulatory arrest. Results. FFA showed initial filling of the fundus venae in 2.5 minutes, and complete filling in 4.5 minutes with partial filling of the arteriae. Arteriae completely filled in 8 minutes, and all of the arteriae and venae filled from 15 to 17 minutes. Color Doppler sonography showed that flow signals were detected in all of the fundus vessels during RCP. Conclusions. FFA and color Doppler sonography are direct and sensitive methods for observing cerebral blood flow and assessing the effect of cerebral perfusion.