Selective jugular cannulation for hypothermic retrograde cerebral perfusion in thoracic aortic operations (reverse over the wire-catheter method)]

We have employed hypothermic retrograde total body perfusion via the caval cannulae as a supportive measures to protect the brain and other systemic organs in operations for aortic arch aneurysms or acute aortic dissection. But occasionally unsatisfactory results ensued, because competent valves located in the internal jugular vein near the jugulo-subclavian junction may block retrograde blood flow to the brain from the caval cannula. To cope with this problem, we designed an easy and safe method to cannulate the internal jugular vein transatrially utilizing guidewire and central venous catheter, and thereafter we have used this technique clinically and obtained good results.