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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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CASE REPORTS VASCULAR PAPERS
The Journal of Cardiovascular Surgery 2000 April;41(2):291-4
Postoperative splanchnic perfusion following the re-construction of thoracoabdominal aortic aneurysm involving abdominal visceral branches. Report of a case
Oshima K., Morishita Y., Ishikawa S., Tsuda K., Ohtaki A., Takahashi T., Suzuki M.
From the Second Department of Surgery Gunma University School of Medicine Gunma, Japan
A 58-year-old man with thoracoabdominal aortic aneurysm involving visceral arteries underwent graft replacement of the thoracoabdominal aorta and associated reconstruction of abdominal visceral branches. Femoro-femoral extracorporeal bypass, intermittent selective visceral arterial perfusion and a staging cross-clamping method of the aorta were utilized at surgery. The total cross-clamping time of the aorta was 165 minutes. The patient’s postoperative course was uneventful with no incidence of hepatic and renal failure or paraplegia. Although postoperative systemic blood pressure and cardiac output recovered to normal values within 7 hrs after the release of aortic clamping, it took 18 hrs for hepatic venous hemoglobin oxygen saturation (ShvO2) to recover. Base excess in arterial blood, lactic acid in arterial and hepatic venous blood, and ketone body ratio in arterial blood (AKBR) and hepatic venous blood (HVKBR) recovered to within normal ranges after 18 hrs of the release of aortic clamping. ShvO2 monitoring is a simple and may be a useful parameter in evaluating postoperative splanchnic perfusion and predicting abdominal organ failure at the time of thoracoabdominal aortic reconstruction involving visceral arteries.