Document Detail


Influence of clamp duration and pressure on endothelial damage in aortic cross-clamping.
MedLine Citation:
PMID:  19934161     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aortic cross-clamping during cardiac operations may injure the vessel wall and cause tissue lesions. This experimental study analyses the influence of the intravascular and external pressure and the duration of aortic cross-clamping on endothelial tissue damage. Fresh porcine aortas (n=20) were tested with intravascular pressures from 30 to 80 mmHg. The external clamp pressure, necessary to occlude the aorta, was applied by using the second cog of a commercial aortic clamp and cross-clamping was performed for 1 and 30 min. The observed pressure curves were compared to the histological findings. For occlusion of the aorta, an external pressure of at least 10-fold higher than the intravascular pressure (max. 812 mmHg) had to be applied. After 30 min of clamping, a complete endothelial destruction was observed, irrespective of intra-aortic pressure. The aortic media remained intact. After 1 min clamping, fractions of intact endothelial cells were left, ranging from 40 to 70% at different intra-aortic pressures. These results indicate that endothelial tissue lesions due to aortic cross-clamping are not avoidable, even in moderate clamp application. The duration of aortic cross-clamping but not intravascular pressure is the pivotal factor. The integrity of the aortic media can be preserved if low-force cross-clamping is achieved.
Authors:
J?rg Babin-Ebell; Kristin Gimpel-Henning; Hans-Hinrich Sievers; Michael Scharfschwerdt
Publication Detail:
Type:  Journal Article     Date:  2009-11-24
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  10     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  168-71     Citation Subset:  IM    
Affiliation:
Cardiovascular Center Bad Neustadt, Salzburger Leite 1, 97616 Bad Neustadt, Germany. joerg.babin-ebell@web.de
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Aorta / injuries*,  pathology,  physiopathology
Blood Pressure
Cardiac Surgical Procedures*
Constriction
Endothelium, Vascular / injuries*,  pathology
Pressure
Swine
Time Factors
Comments/Corrections
Comment In:
Interact Cardiovasc Thorac Surg. 2010 Feb;10(2):171   [PMID:  20089684 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Experimental use of an elastomeric surgical sealant for arterial hemostasis and its long-term tissue...
Next Document:  Impact of high titre of antiphospholipid antibodies on postoperative outcome following pulmonary end...