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Passive Temporary Visceral Shunt from the Axillar Artery as an Adjunct Method during the Open Treatment of Thoracoabdominal Aortic Aneurysm.

Abstract：

BACKGROUND:Distal aortic retrograde perfusion systems like the left heart bypass or femoro-femoral extracorporeal circulation are the methods of reference for organ protection during direct approaches to thoracoabdominal aortic aneurysms. The aim of this work was to evaluate the use of a passive arterial shunt to reduce visceral ischemia during aortic operations when occlusive diseases of the iliac arteries make distal aortic retrograde perfusion inappropriate. METHODS:Ten patients affected by a Crawford type III thoracoabdominal aneurysm (TAA) were operated on between January 2013 and January 2015 with the use of a temporary shunt inserted onto the left axillar artery that allows visceral perfusion immediately after the aorta is opened. The operation was performed after a single dose of heparin (50 UI/kg). The sera lactate levels were measured 2 hr after the last aortic clamp was removed and compared with those obtained from a group of 19 patients operated on for a Crawford type IV TAA during the same period without any arterial shunt. RESULTS:Neither mortality nor paraplegia occurred. The sera lactate levels were lower in the group of patients operated on for a type III TAA (2.57 ± 1) than for a type IV TAA (3.68 ± 1) (P < 0.01, Student's t-test). CONCLUSION:This method was effective for low mesenteric ischemia, easy to perform, and did not require high doses of anticoagulants.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Monnot A,Dusseaux MM,Godier S,Plissonnier D

doi

10.1016/j.avsg.2016.03.031

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

127-131

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(16)30501-5

journal_volume

36

pub_type

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