Kuribayashi R, Chanda J, Abe T
Department of Cardiovascular Surgery, Akita University School of Medicine, Japan.
J Cardiovasc Surg (Torino). 1997 Jun;38(3):271-6.
To find out whether apico-aortic shunt may become an alternative support technique during surgery on the descending thoracic aorta, performance between apico-aortic shunt and aorto-aortic shunt was compared. In 5 sheep weighing 20-25 kg, apico-aortic shunt and aorto-aortic shunt were instituted with covalently bonded heparin coated polyvinyl tube (internal diameter 5 mm). After clamping the descending thoracic aorta, apico-aortic shunt and aorto-aortic shunt were opened for 30 minutes each. Proximal pressure was elevated to 200 mmHg and distal pressure was fallen to 55 mmHg after clamping the descending thoracic aorta. Opening of apico-aortic shunt and aorto-aortic shunt decreased proximal pressure to 178 +/- 14.8 and 173 +/- 12.0 mmHg, respectively (p = 0.57), and raised distal pressure to 82.4 +/- 7.8 and 90.0 +/- 3.5 mmHg, respectively (p = 0.83). The baseline blood flow of the descending thoracic aorta was 1.4-1.5 l/min. Apico-aortic shunt and aorto-aortic shunt were 0.76 +/- 0.16 and 0.80 +/- 0.22 l/min, respectively (p = 0.67). Blood gas tension, pH and BE measurement showed no significant change and difference between apico-aortic shunt and aorto-aortic shunt, and before and after clamping the descending thoracic aorta. Using apico-aortic shunt, interposition of bioprosthetic valved conduit in the descending thoracic aorta in 10 sheep was successfully performed without paraplegia and any other complications. We concluded that apico-aortic shunt may become an alternative support technique during surgery on the descending thoracic aorta in some specific situations.
为了探究心尖-主动脉分流术是否可能成为降主动脉手术期间的一种替代支持技术，对心尖-主动脉分流术与主动脉-主动脉分流术的性能进行了比较。在5只体重20-25千克的绵羊中，使用共价结合肝素涂层的聚乙烯管（内径5毫米）建立心尖-主动脉分流术和主动脉-主动脉分流术。夹闭降主动脉后，心尖-主动脉分流术和主动脉-主动脉分流术各开放30分钟。夹闭降主动脉后，近端压力升高至200毫米汞柱，远端压力降至55毫米汞柱。心尖-主动脉分流术和主动脉-主动脉分流术开放后，近端压力分别降至178±14.8和173±12.0毫米汞柱（p = 0.57），远端压力分别升至82.4±7.8和90.0±3.5毫米汞柱（p = 0.83）。降主动脉的基线血流量为1.4-1.5升/分钟。心尖-主动脉分流术和主动脉-主动脉分流术的血流量分别为0.76±0.16和0.80±0.22升/分钟（p = 0.67）。血气张力、pH值和碱剩余测量显示，心尖-主动脉分流术与主动脉-主动脉分流术之间以及夹闭降主动脉前后均无显著变化和差异。在心尖-主动脉分流术的支持下，成功地对10只绵羊的降主动脉进行了生物人工带瓣管道置换术，未发生截瘫及任何其他并发症。我们得出结论，在心尖-主动脉分流术在某些特定情况下可能成为降主动脉手术期间的一种替代支持技术。
