Alternate venous drainage and return of warmed blood combined with continuous hypothermic visceral perfusion. A new adjunct of thoracoabdominal aortic aneurysm repair.
OBJECTIVE
As a new adjunct to surgical repair for a thoracoabdominal aortic aneurysm, we have devised and used visceral perfusion in combination with alternate venous drainage and return of warmed blood in 4 patients.


METHODS
Surgical repair of a thoracoabdominal aortic aneurysm of Crawford type III (n = 1) or type IV (n = 3) was performed. During visceral branch reconstruction, hypothermic blood (30-32 degrees C) was perfused continuously to each visceral and renal artery at a total flow rate of 300 ml/min, in combination with alternate venous drainage and return of warmed blood to the inferior vena cava.


RESULTS
The visceral and renal perfusion time was 115 +/- 55 (with a range from 52 to 190) minutes. All 4 patients recovered uneventfully.


CONCLUSIONS
Alternate venous drainage and return of warmed blood combined with continuous hypothermic visceral perfusion were a useful adjunct to thoracoabdominal aneurysm repair during reconstruction of visceral and renal arteries.
Division of Thoracic and Cardiovascular Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Yokkaichi, Japan.
H
H
Okamoto
K
K
Fujimoto
A
A
Tamenishi
T
T
Niimi
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000628:therapy*; D001769:Blood; D004322:Drainage; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015424:Reperfusion / Q000379:methods*