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Annals of Vascular Surgery

, Volume 2, Issue 3, pp 261–267 | Cite as

Mesenteric shunting during thoracoabdominal aortic clamping to prevent disseminated intravascular coagulation in dogs

  • Jon R. Cohen
  • William Schroder
  • Joseph Leal
  • Leslie MD Wise
Original Articles
  • 7 Downloads

Abstract

The current study was undertaken to determine if cold crystalloid perfusion of the mesenteric circulation or continuous arterial shunting into the superior mesenteric artery would prevent the subsequent development of disseminated intravascular coagulation in a dog model. Twenty-two dogs were divided into four groups: those with distal aortic occlusion; those with isolated washout of the mesenteric circulation via the superior mesenteric artery with cold crystalloid; those with continuous isolated arterial perfusion of the superior mesenteric artery via an open proximal aorta; and those with shunting of blood Into the superior mesenteric artery from the proximal aorta with an Inahara-Pruitt shunt. Coagulation parameters were measured for 24 hours and compared to the results with 32 dogs in the following groups: sham operation; supraceliac aortic occlusion for 30 minutes, 60 minutes, 90 minutes; superior mesenteric occlusion for 90 minutes; and celiac axis occlusion for 90 minutes. Shunting or direct arterial perfusion of the superior mesenteric artery prevented disseminated intravascular coagulation from occurring. Infrarenal aortic occlusion resulted in no change in any of the coagulation factors, whereas crystalloid perfusion of the superior mesenteric artery resulted in death In all animals. These results indicate that the disseminated intravascular coagulation that occurs with supraceliac aortic occlusion or superior mesenteric occlusion of greater then one hour can be prevented by continuous arterial perfusion of the superior mesenteric artery during proximal aortic clamping.

Key Words

Mesenteric shunting disseminated intravascular coagulation experimental aortic occlusion 

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References

  1. 1.
    CRAWFORD ES, CRAWFORD JL, SAFI HJ, COSELLI JS, HESS KR, BROOKS B, NORTON HJ, GLAESER DH. Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients.J Vase Surg 1986;3:389–404.CrossRefGoogle Scholar
  2. 2.
    LIVESAY JJ, COOLEY DA, VENTEMIGLIA RA, MONTERO CG, WARIAN RK, BROWN DM, DUNCAN JM. Surgical experience in descending thoracic aneurysmectomy with and without adjuncts to avoid ischemia.Ann Surg 1985;39:37–44.Google Scholar
  3. 3.
    CUNNINGHAM JN Jr, LASCHINGER JC, MERKIN HA, NATHAN IM, COLVIN S, RANSOHOFF J, SPENCER FC. Measurement of spinal cord ischemia during operations upon the thoracic aorta.Ann Surg 1982;196:285–295.CrossRefPubMedGoogle Scholar
  4. 4.
    MIZHARI EM, CRAWFORD ES. Somatosensory-evoked potentials during reversible spinal cord ischemia in man.Electroencephalogr Clin Neurophysiol 1984;58:120–126.CrossRefGoogle Scholar
  5. 5.
    KRIEGER KH, SPENCER FC. Is paraplegia after repair of coarctation of the aorta due principally to distal hypotension during aortic cross-clamping?Surgery 1985;97:2–1.PubMedGoogle Scholar
  6. 6.
    CRAWFORD ES. Thoracoabdominal and abdominal aortic aneurysms involving renal, superior mesenteric, and celiac arteries.Ann Surg 1974;179:763–772.CrossRefPubMedGoogle Scholar
  7. 7.
    CRAWFORD ES, SNYDER DM, CHO GC, ROEHM JOF Jr. Progress in the treatment of thoracoabdominal and abdominal aortic aneurysms involving celiac, superior mesenteric, and renal arteries.Ann Surg 1978;188:404–422.CrossRefPubMedGoogle Scholar
  8. 8.
    COHEN JR, ANGUS L, ASHER A, CHANG JB, WISE L. Disseminated intravascular coagulation as a result of supraceliac clamping: implications for thoracoabdominal aneurysm repair.Ann Vase Surg 1987;5:552–557.CrossRefGoogle Scholar
  9. 9.
    Guide for the Care in the Use of Laboratory Animals. Bethesda: NIH Publication No 80–23, Revised 1978.Google Scholar
  10. 10.
    BENGMARK S, HAFSTROM LO, KORSAN BENGTSEN K. Effects on blood clotting and circulation of autologous connective tissue homogenate infusion in dogs.J Trauma 1969;9: 36–243.CrossRefGoogle Scholar
  11. 11.
    DINBAR A, RANGEL DM, FONKALSRUD EW. Effects of hepatic ischemia on coagulation in primates. Application to liver transplantation.Surgery 1970;8:269–276.Google Scholar
  12. 12.
    HAFSTROM LO, KORSAN-BENGTSEN K, BENGMARK S. Changes in blood clotting and fibrinolysis after liver ischemia in pigs.Am J Surg 1974;127:300–305.CrossRefPubMedGoogle Scholar

Copyright information

© Annals of Vascular Surgery Inc. 1988

Authors and Affiliations

  • Jon R. Cohen
    • 1
    • 2
  • William Schroder
    • 1
    • 2
  • Joseph Leal
    • 1
    • 2
  • Leslie MD Wise
    • 1
    • 2
  1. 1.Department of SurgeryLong Island Jewish Medical CenterNew Hyde Park
  2. 2.State University of New YorkStony Brook

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