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[Portal and hepatic circulation during cardio-pulmonary bypass in chronic congestive liver--an experimental study]
1Second Department of Surgery, Kagoshima University School of Medicine, Japan.
Abstract:
Hemodynamic changes of portal and hepatic circulation in dogs with chronic congestive liver (CCL) have been studied with reference to cardio-pulmonary (C-P) bypass. The CCL dogs were provided by means of cut of the chordae of tricuspid valve followed by breeding for 4 to 41 months. Five of CCL dogs and 10 of control dogs were served for C-P bypass for 90 minutes. The measurements of portal venous pressure (PVP), wedged hepatic venous pressure (WHVP) and hepatic tissue blood flow (HBF) by hydrogen gas clearance method were made before and during C-P bypass. Results were as follows. 1. HBF of CCL dogs after laparotomy decreased significantly (p less than 0.001) in comparison of control dogs (31.7 +/- 14.4 vs. 62.7 +/- 23.3 ml/min/100g). 2. During the C-P bypass, the rates of rise of PVP and WHVP in CCL dogs revealed a lesser prominent than those of control dogs. 3. No reduction of the HBF was seen during the C-P bypass in CCL dogs. These results lead the conclusion that the portal and hepatic circulation of CCL dogs poorly adapted to an unphysiological condition of C-P bypass. It is considered, however, that CCL itself is not a state of absolute contraindication for C-P bypass in open cardiac surgery.