title: The pathophysiology of aortic cross-clamping.
abstract: During open aortic surgery, interrupting the blood flow through the aorta by applying a cross-clamp is often a key step to allow for surgical repair. As a consequence, ischemia is induced in parts of the body distal to the clamp site. This significant alteration in the blood flow is almost always associated with hemodynamic changes. Upon release of the cross-clamp, the blood flow is restored, triggering an ischemia-reperfusion response, leading to many pathophysiological processes such as inflammation, humoral changes, and metabolite circulation that could lead to injury in many organ systems and may significantly influence the postoperative outcome. It is therefore important to understand these processes and how they can be treated in order to allow for safe surgical aortic repairs while ensuring the best possible outcomes.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: mzammert@partners.org.
authors.forename: Martin
authors.initials: M
authors.lastname: Zammert
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Gelman
mesh_terms: D001011:Aorta / Q000473:pathology* / Q000601:surgery*; D003250:Constriction; D006439:Hemodynamics; D006801:Humans; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
keywords: aortic cross-clamping; blood shift; ischemia-reperfusion injury; postconditioning