Online Journal
IF値: 1.878(2021年)→1.8(2022年)


Journal of Medical Ultrasonics

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2010 - Vol.37

Vol.37 No.03

State of the Art(特集)

(0305 - 0308)


Transcranial Doppler (TCD) monitoring during cardiovascular surgery

榛沢 和彦

Kazuhiko HANZAWA


Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medicine

キーワード : TCD, CBF, cardiovascular surgery, microembolic signals, cerebral impairment


The leading causes of cerebral injury during cardiovascular (CV) surgery are cerebral blood flow (CBF) insufficiency and embolism. TCD can detect both CBF velocity and micro-emboli in cerebral arteries. However, the middle cerebral artery (MCA) cannot always be detected by the temporal bone approach in elderly Japanese, in whom monitoring of the extra-cranial internal carotid artery (ICA) by the infra-mandible approach is recommended. CBF velocity measured by TCD is useful for cardiopulmonary bypass or selective cerebral perfusion. Most HITS/MES detected by TCD during CV surgery indicate micro-bubbles. However, many micro-bubbles cause cerebral injury. Cerebral protection therapy is needed in case numerous HITS/MES are detected during CV surgery.