• T O Eide, J Aasland, P Romundstad, R Stenseth, O D Saether, P Aadahl, and H O Myhre.
• Department of Surgery, St. Olavs Hospital, University Hospital of Trondheim, Trondheim, Norway.
• Eur Surg Res. 2005 Nov 1;37(6):330-4.

Aim Of The StudyIn the clinical situation there is discrepancy between various investigations regarding the cardiac response of thoracic aortic cross-clamping. The aim was therefore to investigate the hemodynamic response and blood gases during proximal aortic cross-clamping (XC) in patients operated for descending thoracic and thoracoabdominal aortic aneurysm without circulatory support.Patients And MethodsAltogether 51 patients operated on for thoracoabdominal (n=31) or descending thoracic aortic aneurysm (n=20) were included in the investigation. All patients were operated with aortic XC, but no circulatory support was applied. Hemodynamic variables and blood gases were recorded before and during XC.ResultsA significant increase in cardiac output during XC from 4.7 to 6.0 liters/min was observed (p<0.01). There was a similar percentual increase in heart rate and also the proximal systolic blood pressure increased. A metabolic acidosis occurred during XC.ConclusionCardiac output was significantly increased during XC in patients operated on for thoracoabdominal or descending thoracic aneurysm using direct aortic XC without circulatory support. Simultaneously, the heart rate was increased and there was a hyperdynamic circulatory state proximal to the aortic clamp. Redistribution of the blood volume in addition to catecholamine release may be responsible for the observed changes. These observations may influence the selection of operative strategy for some of these patients.Copyright (c) 2005 S. Karger AG, Basel.

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