High-risk aortic aneurysm repair with partial cardiopulmonary bypass.
Two patients with severe cardiac dysfunction and measured left ventricular ejection fractions of 18% and 20% underwent aneurysm repair with the use of femoral vein--femoral artery partial cardiopulmonary bypass. While the aorta was clamped, blood was withdrawn through the venous cannula, and oxygenated blood was delivered to the legs through the arterial cannula. This procedure allowed clamping and unclamping of the aorta to proceed without hemodynamic fluctuation. Intraoperatively, cardiac output, mean arterial pressure, pulmonary artery diastolic pressure, right atrial pressure, pulmonary capillary wedge pressure, and systemic vascular resistance were measured. Both patients recovered, which indicates that this technique may be safely undertaken in the severely compromised patient with cardiac disease.
Department of Surgery, Rochester General Hospital, NY 14621.
W M
WM
Fiore
K
K
Ouriel
R
R
Green
J E
JE
Geary
D000368:Aged; D001012:Aorta, Abdominal; D001014:Aortic Aneurysm / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006333:Heart Failure; D006801:Humans; D008297:Male; D012307:Risk Factors; D013318:Stroke Volume