Cerebral haemodynamics during thoracic- and thoracoabdominal aortic aneurysm repair

To investigate cerebral haemodynamics during operations for thoracic and thoracoabdominal aortic aneurysms. Prospective clinical study. 10 patients operated on consecutively with resection for thoracic (5) or thoracoabdominal aortic (5) aneurysms. Blood flow velocity of the middle cerebral artery wa...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 1996-07, Vol.12 (1), p.81-85
Main Authors: S˦ther, O.D., Juul, R., Aadahl, P., Strømholm, T., Myhre, H.O.
Format: Article
Language:English
Subjects:
Aged
Aortic Aneurysm, Abdominal - surgery
Aortic Aneurysm, Thoracic - surgery
Aortic cross-clamping
Blood Flow Velocity
Blood Pressure
Blood Volume
Cardiopulmonary Bypass
Cerebral Arteries - diagnostic imaging
Cerebral Arteries - physiopathology
Cerebral blood flow velocity
Cerebrospinal Fluid Pressure
Cerebrovascular Circulation
Female
Hemodynamics
Humans
Male
Middle Aged
Middle cerebral artery
Prospective Studies
Pulsatile Flow
Thoracoabdominal aneurysm repair
Transcranial Doppler
Ultrasonography, Doppler
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Summary:To investigate cerebral haemodynamics during operations for thoracic and thoracoabdominal aortic aneurysms. Prospective clinical study. 10 patients operated on consecutively with resection for thoracic (5) or thoracoabdominal aortic (5) aneurysms. Blood flow velocity of the middle cerebral artery was measured through a temporal approach using a TC Doppler with a 2 MHz probe. Recordings were made during induction of anaesthesia and performed continuously before, during and after cross-clamping of the aorta. Following 10 min. of aortic cross-clamping blood flow velocity of the middle cerebral artery increased from 44 to 55 cm/s ( p < 0.01). A further increase to 69 cm/s ( p < 0.01) was observed 5 min after declamping. The pulsatility index averaged 0.74 increasing to 1.21 ( p < 0.05) at clamping and 0.87 ( p < 0.05) after declamping. There was an increased blood flow velocity of the middle cerebral artery during cross-clamping of the descending thoracic aorta in patients operated on for thoracic and thoracoabdominal aortic aneurysms. This increase in cerebral blood flow and blood volume could explain the acute increase in cerebrospinal fluid pressure observed during cross-clamping of the thoracic aorta.
ISSN:1078-5884
1532-2165
DOI:10.1016/S1078-5884(96)80280-2