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Cross clamping the lower abdominal aorta during vascular surgery
Archivum Chirurgicum Neerlandicum
|January 1, 1979
Summary
Cross clamping the abdominal aorta significantly increases systemic blood pressure during surgery for aortic aneurysms. However, it does not affect right or left heart filling pressures, even in patients with pre-existing abnormalities.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Vascular Surgery
Background:
- Abdominal aortic aneurysm and occlusive disease require surgical intervention.
- Neuroleptanaesthesia is used for these procedures.
- Hemodynamic effects of aortic cross-clamping are critical to understand.
Purpose of the Study:
- To investigate the impact of lower abdominal aortic cross-clamping on systemic and cardiac pressures.
- To assess hemodynamic responses during neuroleptanaesthesia for aortic surgery.
Main Methods:
- Studied 17 patients undergoing surgery for abdominal aortic aneurysm or occlusive disease.
- Monitored systemic blood pressure, right heart pressure (central venous pressure - CVP), and left heart pressure (pulmonary capillary wedge pressure - PCWP).
- Measurements were taken before and after aortic cross-clamping under neuroleptanaesthesia.
Main Results:
- Systemic systolic blood pressure increased by 24 mmHg (p < 0.01).
- Systemic diastolic blood pressure increased by 8 mmHg (p < 0.01).
- No significant influence of aortic cross-clamping on CVP or PCWP was observed, even in patients with abnormal baseline pressures.
Conclusions:
- Lower abdominal aortic cross-clamping causes a significant hypertensive response.
- Cardiac filling pressures (CVP and PCWP) remain stable during this maneuver.
- These findings are important for managing hemodynamics in patients undergoing aortic surgery.