• Yoshiyuki Maekawa, Takahiko Sakamoto, Kentaro Umezu, Nobuo Ohashi, Yorikazu Harada, Satoshi Yasukochi, Kiyohiro Takigiku, Hikoro Matsui, Nao Inoue, Yasuko Morimoto, Shigeo Watanabe, and Hiromitsu Mori.
• Division of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
• Kyobu Geka. 2011 Nov 1;64(12):1061-4.

ObjectiveThe left superior vena cava (LSVC) is often complicated with congenital heart defect. Although we simply clamp LSVC during cardio-pulmonary bypass (CPB), appropriateness of this technique has not been clarified. We noninvasively evaluate cerebral tissue oxygenation while the clamping of LSVC under CPB by near-infrared spectroscopy (NIRS).MethodsSix children (3 male and 3 female; aged 1.0 +/- 0.6 year) undergoing open heart surgery were studied. The NIRO 300 was incorporated into an established multimodal monitoring system. Tissue oxygenation index (TOI), oxyhemoglobin (O2Hb), and deoxyhemoglobin (HHb) changes were assessed and compared with LSVC pressure.ResultsThere were no significant changes in cerebral oxygen delivery after LSVC clamp. LSVC pressure increased from 7.3 +/- 1.8 mmHg to 20.1 +/- 2.6 just after LSVC clamp, but gradually decreased without any maneuver.ConclusionThese data demonstrated that LSVC could be safely clamped when LSVC pressure was under 30 mmHg.

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