Simplified, controlled limb reperfusion and simultaneous revascularization for acute aortic occlusion.
A 62-year old patient was admitted with a 24-hour history of ischemia in both legs caused by acute distal aortic occlusion and had had a total loss of sensitivity and motor function for 8 hours. Preoperative serum creatine phosphokinase level was 10,900 IU/ml. During aortofemoral reconstruction, both limbs were reperfused with a potassium-free, blood-cardioplegia-like perfusate. Fasciotomies were not necessary. After operation, maximal serum creatine phosphokinase levels remained below 10,000 IU/ml. Limb sensitivity and motor function were normal. Even for prolonged acute aortoiliac occlusion, a simplified controlled limb-reperfusion may preserve skeletal muscle and nerve function and prevent local and systemic complications caused by reperfusion damage.
Vogt
P R
PR
Clinic for Cardiovascular Surgery, University Hospital Zurich, Switzerland.
von Segesser
L K
LK
Pagotto
E
E
Lijovic
T
T
Turina
M I
MI
D001018:Aortic Diseases / Q000150:complications / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D001769:Blood; D002314:Cardioplegic Solutions / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000294:innervation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D010243:Paralysis / Q000209:etiology; D015424:Reperfusion / Q000379:methods; D015427:Reperfusion Injury / Q000517:prevention & control; D012678:Sensation Disorders / Q000209:etiology
D002314:Cardioplegic Solutions; D003402:Creatine Kinase