RESULTS OF SURGICAL TREATMENT FOR THORACOABDOMINAL ANEURYSM USING CARDIOPULMONARY BYPASS UNDER MODERATE HYPOTHERMIA AND SELECTIVE VISCERAL ARTERY PERFUSION

山下 長司郎, 安宅 啓二, 吉田 正人, 杉本 貴樹, 脇山 英丘, 岡田 昌義

RESULTS OF SURGICAL TREATMENT FOR THORACOABDOMINAL ANEURYSM USING CARDIOPULMONARY BYPASS UNDER MODERATE HYPOTHERMIA AND SELECTIVE VISCERAL ARTERY PERFUSION

山下長司郎

Second Division, Department of Surgery, Kobe University School of Medicine
安宅啓二

Second Division, Department of Surgery, Kobe University School of Medicine
吉田正人

Second Division, Department of Surgery, Kobe University School of Medicine
杉本貴樹

Second Division, Department of Surgery, Kobe University School of Medicine
脇山英丘

Second Division, Department of Surgery, Kobe University School of Medicine
岡田昌義

Second Division, Department of Surgery, Kobe University School of Medicine

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From 1994 to 1997, 11 consecutive patients with thoracoabdominal aneurysms underwent surgery using cardiopulmonary bypass under moderate hypothermia (33 degrees C) and selective visceralartery perfusion for spinal cord and visceral organ protection. Distal perfusion pressure was maintained above 60 mmHg (mean) during cardiopulmonary bypass. In the four patients, one or two pairs of large intercostal arteries between Th10 and L2 were reimplanted. In the four patients, visceral and renal arteries were reconstructed. Surgical mortality rate within 1 month was 18.2% (2/11). One patient died of bleeding from old empyema and another of multiple organ failure. No patients had paraplegia. In conclusion, cardiopulmonary bypass with selective visceral artery perfusion under moderate hypothermia may contribute to the prevention of the occurrence of paraplegia and acute renal failure.