Alternate venous drainage and return of warmed blood combined with continuous hypothermic visceral perfusion. A new adjunct of thoracoabdominal aortic aneurysm repair.

Abstract

As a new adjunct to surgical repair for a thoracoabdominal aortic aneurysm, we have devised and used visceral perfusion in combination with alternate venous drainage and return of warmed blood in 4 patients. Surgical repair of a thoracoabdominal aortic aneurysm of Crawford type III (n = 1) or type IV (n = 3) was performed. During visceral branch reconstruction, hypothermic blood (30-32 degrees C) was perfused continuously to each visceral and renal artery at a total flow rate of 300 ml/min, in combination with alternate venous drainage and return of warmed blood to the inferior vena cava. The visceral and renal perfusion time was 115 +/- 55 (with a range from 52 to 190) minutes. All 4 patients recovered uneventfully. Alternate venous drainage and return of warmed blood combined with continuous hypothermic visceral perfusion were a useful adjunct to thoracoabdominal aneurysm repair during reconstruction of visceral and renal arteries.