Antegrade cerebral perfusion reduces apoptotic neuronal injury in a neonatal piglet model of cardiopulmonary bypass

The Journal of Thoracic and Cardiovascular Surgery
Valerie Y ChockV Mohan Reddy

Abstract

Neonates with congenital heart disease might require surgical repair with deep hypothermic circulatory arrest, a technique associated with adverse neurodevelopmental outcomes. Antegrade cerebral perfusion is thought to minimize ischemic brain injury, although there are no supporting experimental data. We sought to evaluate and compare the extent of neurologic injury in a neonatal piglet model of deep hypothermic circulatory arrest and antegrade cerebral perfusion. Neonatal piglets undergoing cardiopulmonary bypass were randomized to deep hypothermic circulatory arrest or antegrade cerebral perfusion for 45 minutes. Animals were killed after 6 hours of recovery, and brain tissue was stained for evidence of cellular injury and for the apoptotic markers activated caspase 3 and cytochrome c translocation from mitochondria to cytosol. Piglets from the antegrade cerebral perfusion group exhibited less apoptotic or necrotic injury (4 +/- 3 vs 29 +/- 12 cells per field, P = .03). The piglets undergoing antegrade cerebral perfusion also had less evidence of apoptosis, with fewer cells staining for activated caspase 3 (57 +/- 8 vs 93 +/- 9 cells per field, P = .001) or showing cytochrome c translocation (6 +/- 2 vs 15 +/- 4 cells per fie...Continue Reading

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Citations

Sep 26, 2013·Therapeutic Hypothermia and Temperature Management·Zheng GuoWei Wang
Sep 8, 2011·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Frank H Kern
Mar 31, 2010·Pediatric Research·Erin L AlbersBethann McLaughlin
Sep 21, 2013·The Annals of Thoracic Surgery·Ivan Ricardo Argueta-MoralesWilliam M Decampli
Jun 30, 2009·The Annals of Thoracic Surgery·Jorge D SalazarRobert DiGeronimo
Apr 9, 2008·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Charles D Fraser, Dean B Andropoulos
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Feb 20, 2021·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Nagarajan RamadossSudeep Verma

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