Intraluminal shunt for the thoracic aorta: Spinal cord and visceral blood flow in acute studies

Steven J. Van Voorst, Samir Rustom, James W. Pate, Amado G. Maijub, Charles Leffler

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aortic cross-clamping during surgery of the thoracic aorta may result in paraplegia or kidney failure. Difficulties associated with external shunts and bypasses have limited their use. Therefore we compared intraluminal shunting to the nonshunting method of repair in neonatal pigs. Blood flow to the spinal cord and viscera was measured with radiolabeled microspheres before, during, and after thoracic aortic cross-clamping or shunting. Two no-shunt groups were studied: One group was clamped distal to the left subclavian artery for 30 minutes and the other for 1 hour. In the intraluminal shunt group, a shunt was placed in the aorta just below the ligamentum arteriosum for 1 hour; it was then removed and the aorta repaired. In the no-shunt groups, there was virtually no blood flow to the lower cord and viscera during the cross-clamp period. Hyperemia of the lower thoracic and lumbar cord occurred in the no-shunt 30-minute group 15 minutes after clamp removal. In the no-shunt 60-minute group, flow initially returned to the lumbar cord but then declined; and after 1 hour of reperfusion it was significantly lower than baseline. Renal blood flow was even more severely affected in the no-shunt 60-minute group, with minimal recovery during the reperfusion period. In the intraluminal shunt group baseline spinal cord and visceral blood flow were maintained during thoracic aortic cross-clamping, without the problems associated with extracorporeal circulation.

Original languageEnglish (US)
Pages (from-to)939-943
Number of pages5
JournalWorld Journal of Surgery
Volume18
Issue number6
DOIs
StatePublished - Nov 1 1994

Fingerprint

Thoracic Aorta
Fetal Blood
Spinal Cord
Constriction
Viscera
Reperfusion
Aorta
Thorax
Subclavian Artery
Extracorporeal Circulation
Renal Circulation
Paraplegia
Hyperemia
Microspheres
Renal Insufficiency
Swine

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Intraluminal shunt for the thoracic aorta : Spinal cord and visceral blood flow in acute studies. / Van Voorst, Steven J.; Rustom, Samir; Pate, James W.; Maijub, Amado G.; Leffler, Charles.

In: World Journal of Surgery, Vol. 18, No. 6, 01.11.1994, p. 939-943.

Research output: Contribution to journalArticle

Van Voorst, Steven J. ; Rustom, Samir ; Pate, James W. ; Maijub, Amado G. ; Leffler, Charles. / Intraluminal shunt for the thoracic aorta : Spinal cord and visceral blood flow in acute studies. In: World Journal of Surgery. 1994 ; Vol. 18, No. 6. pp. 939-943.
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