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Near infrared spectroscopy for controlling the quality of distal leg perfusion in remote access cardiopulmonary bypass

Innsbruck Medical University, Innsbruck, Austria

Received 13 March 2008; received in revised form 15 August 2008; accepted 22 August 2008.

^_* Corresponding author. Address: Department of Cardiac Surgery, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Tel.: +43 512 504; fax: +43 512 504 22528. (Email: Thomas.Schachner{at}i-med.ac.at).

The prevention of leg ischemia is necessary in all patients undergoing femoral artery cannulation for extracorporeal circulation. Near infrared spectroscopy (NIRS) is an established non-invasive method for measuring tissue oxygen saturation. Ten patients underwent robotically assisted endoscopic coronary surgery or ASD repair on the arrested heart using aortic endo-occlusion catheters. They were monitored by transcutaneous NIRS (placed on both lower legs) for quality control of distal leg perfusion during femoral access cardiopulmonary bypass. The baseline NIRS values were 61 (52–80) on the cannulated side versus 70 (53–80) on the contralateral leg (p = n.s.). During clamping of the femoral artery for installation of the remote access perfusion system the tissue oxygen saturation dropped to 38 (18–58) (p = 0.001 vs baseline) while it remained stable on the contralateral leg. After successful implantation of the distal leg perfusion the NIRS values normalized to similar amounts on both legs. We conclude that transcutaneous NIRS of the lower legs might be a useful non-invasive tool for monitoring leg perfusion in patients undergoing extracorporeal circulation via the femoral vessels.

Key Words: Near infrared spectroscopy • NIRS • Endoscopic • Robotic • Cardiac surgery

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