title: Intraluminal shunt for the thoracic aorta: blood flow and function in chronic studies.
abstract: BACKGROUND
  Aortic cross-clamping during operations on the thoracic aorta may result in paraplegia or kidney failure.
  
  
  METHODS
  A nonshunting method of repair was compared with intraluminal shunting in two groups of young pigs: the no-shunt group, which received simple aortic cross-clamping at the ligamentum for 15 minutes; and the shunt group, which received an aortic graft with a temporary intraluminal shunt and balloon occlusion of the inferior vena cava only during shunt insertion and removal. Blood flow to the spinal cord and viscera was measured with radiolabeled microspheres on days 1, 3, 5, and 7 after operation. Renal and neurologic function and histology also were studied.
  
  
  RESULTS
  In the no-shunt group, there was hyperemia of the lumbar cord compared with the shunt group. There were no significant differences in renal cortex blood flow or creatinine clearance. Seven of 10 animals in the no-shunt group had paraplegia, compared with none in the shunt group. Histologic studies of the lower lumbar cord showed bilateral central necrosis of gray matter in the no-shunt group, but no evidence of necrosis in the shunt group.
  
  
  CONCLUSIONS
  An intraluminal shunt allowed thoracic aorta reconstruction without paraplegia.
authors.affiliation: Department of Surgery, University of Tennessee College of Medicine, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Van Voorst
authors.forename: G S
authors.initials: GS
authors.lastname: Labranche
authors.forename: S
authors.initials: S
authors.lastname: Rustom
authors.forename: A F
authors.initials: AF
authors.lastname: Jukkola
authors.forename: C W
authors.initials: CW
authors.lastname: Leffler
mesh_terms: D000818:Animals; D001013:Aorta, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D003250:Constriction; D004195:Disease Models, Animal; D007511:Ischemia / Q000517:prevention & control*; D010264:Paraplegia / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control*; D012039:Regional Blood Flow; D013116:Spinal Cord / Q000098:blood supply* / Q000473:pathology; D013552:Swine; D014781:Viscera / Q000098:blood supply*