Objective To evaluate the applicability of Transcranial Doppler (TCD) monitoring in brain protection in the process of aortic dissection surgical procedure. Methods From Feburary 2007 to November 2007, six patients with type I aortic dissection underwent surgical procedure in Xuanwu Hospital of Capital Medical University. All patients are male with their age ranged from 48 to 60 years. During the operation, right subclavian arterial cannulation technique was used to protect the brain, and TCD monitoring was adopted to guide cerebral perfusion. The function of nervous system after operation was observed, and the minimental state examination (MMSE) was used to assess the cognitive function of the patients. A twoyear followup was done to monitor patients’ aorta condition. Results The time of cardiopulmonary bypass (CPB) was 136 to 350 minutes. The time of selected cerebral perfusion was 20 to 65 minutes. The lowest cerebral blood flow was 31% of basic level according to TCD monitoring. All patients were successfully treated without neurological complication and cognitive dysfunction when discharged from hospital. MMSE score was 28 to 30 points. During the twoyear followup after operation, all aortic false lumen were closed and there was no dissection recurrence. Conclusion Monitoring blood change with TCD monitoring technique is safe and effective in evaluating brain protection by selective cerebral perfusion in aortic dissection surgical procedure.
ObjectiveTo study the relation between daily activity that can make right atrium pressure rise (such as abdominal belt, sighs, weight lifting) and patent foramen ovale (PFO). MethodsA total of 122 cases of positive patients by the routine transcranial Doppler (TCD) foaming test between 2014 and 2015 were collected. Forty-one patients underwent TCD foaming test in the case of abdominal belt, 41 in the case of sighs, and 40 in the case of weight lifting. We recorded the right to left shunting of the above three cases, and compared them with the normal TCD foam test. ResultsThere was a significant difference in the positive rate between the sigh group and abdominal belt group, and between the sigh group and weight lifting group (χ2=10.5, 7.40; P<0.01). The positive rate in the abdominal belt group was not significantly different from that of the weight lifting group (χ2=0.314, P>0.05). In the sigh group, the sigh shunting volume was significantly higher than that when the patients were at rest. The shunting volume was the biggest when the patients had Valsalva movement, followed by sighing and resting. ConclusionThe daily activity that can make right atrium pressure rise (such as abdominal belt, sighs, weight lifting) can increase the shunting flow from the right to the left. The highest positive rate occurs when patients sigh. This study can provide a certain theoretical basis for the pathogenesis of patent foramen ovale and cryptogenic stroke.