Centrifugal pump support for distal aortic perfusion during repair of traumatic thoracic aortic injury.
Paraplegia from ischemic injury of the spinal cord and renal failure from inadequate perfusion of the kidneys may occur from aortic cross-clamping during repair of traumatic thoracic aortic injuries. After Institutional Review Board approval, we retrospectively reviewed the charts of 26 patients surgically treated for traumatic transection of the descending thoracic aorta during a 14 year period (1987-2001), using centrifugal pump (Sarns) support for distal aortic perfusion. The study group comprised 19 males and 7 females, whose ages ranged from 15 to 69 years. For all but 1 patient, who fell from a flagpole, the injuries were incurred in motor vehicle accidents. Aortic cross-clamp time lasted between 5 to 78 min (median = 40 min). Mean arterial pressure ranged from 50 to 80 mm Hg (median = 70 mm Hg). All patients survived operation without developing paraplegia or renal failure. Distal centrifugal pump perfusion during repair of traumatic injury of the descending thoracic aorta is a valuable adjunct during surgical treatment and aids in preservation of spinal cord and renal function.
Walls
Joseph T
JT
Department of Surgery, Division of Cardiothoracic Surgery, University of Missouri-Columbia 65212, USA. wallsj@health.missouri.edu
Curtis
Jack J
JJ
McKenney-Knox
Charlotte A
CA
Schmaltz
Richard A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D001013:Aorta, Thoracic / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure / Q000502:physiology; D002498:Centrifugation; D003250:Constriction; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D051437:Renal Insufficiency / Q000503:physiopathology / Q000517:prevention & control*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors