What does cross-clamping the aorta do?

From Wikipedia, the free encyclopedia. An aortic cross-clamp is a surgical instrument used in cardiac surgery to clamp the aorta and separate the systemic circulation from the outflow of the heart. An aortic cross-clamping procedure serves, for example, in the repairing of coarctation of the aorta.

Where is the aorta clamped?

THE aorta at the thoracic or abdominal levels is cross-clamped during surgical procedures for trauma and sometimes for resuscitation; more often, however, it is cross-clamped for surgical treatment of abdominal, thoracic, or thoracoabdominal aneurysm or of peripheral vascular disease complicated by ischemia of the …

What is a normal cross-clamp time?

In the majority of patients, 30–90 min of cross-clamp time was required. Less than 2% of patients required cross-clamp times greater than 120 min and these patients were excluded for the reasons noted above.

What causes Declamping shock?

Aortic declamping leads to “declamping shock” which is produced by metabolic and hemodynamic factors. Metabolites from the ischemic tissues below the clamp are released into the systemic circulation. The resultant acidosis further deteriorates the contractility of the ischemic heart [12, 13].

What is cross-clamp fibrillation?

Cross-clamp fibrillation is a well established method of performing coronary grafting, but its clinical effect on the myocardium is unknown. We sought to measure these effects clinically using the Khuri Intramyocardial pH monitor.

What is cardioplegia solution?

Solution. Cardioplegia Solution A is a sterile, non-pyrogenic solution for cardiac perfusion in a Viaflex bag. It is used to induce cardiac stasis and to protect the myocardium during open-heart surgery.

What is the clamp time in cardiac surgery?

Mortality of patients with an LVEF <40% was the same or higher at cross-clamp times of 1–30 min than at 91–120 min. Conclusions: Despite modern techniques of cardio protection, XCL time remains an independent predictor of mortality in patients with preserved preoperative contractile function.

What is Declamping shock?

[ dē-klăm′pĭng ] n. The occurrence of shock or hypotension following the abrupt release of clamps from a large portion of the vascular bed, such as the aorta, that is believed to be caused by transient pooling of blood in a previously ischemic area. declamping shock.

Where is the Supraceliac aorta?

The supraceliac aorta was defined as the portion of the aorta that extends 6 ern above the celiac artery and overlies the body of the twelfth thoracic vertebra.

What is cardioplegia solution made of?

Each 100 mL of solution contains Calcium Chloride Dihydrate USP 17.6 mg, Magnesium Chloride, Hexahydrate USP 325.3 mg, Potassium Chloride USP 119.3 mg and Sodium Chloride USP 643 mg in Water for Injection, USP.

What is the pathophysiology of aortic cross clamping?

The pathophysiology of aortic cross-clamping During open aortic surgery, interrupting the blood flow through the aorta by applying a cross-clamp is often a key step to allow for surgical repair. As a consequence, ischemia is induced in parts of the body distal to the clamp site.

What is the clinical significance of cross-clamping of the thoracic aorta?

A clinically relevant message from these findings [34] is that during cross-clamping of the thoracic aorta, which subjects vitally important organs (liver, kidneys, and spinal cord) to severe ischemia, proximal and distal aortic pressures should be maintained as great as the heart can withstand.

What is the effect of cross clamping on thoracic aorta in dogs?

Cross-clamping of the thoracic aorta is associated with almost a twofold increase in blood flow through the upper part of the body, [19-21] more than a threefold increase in blood flow through the muscle proximal to the clamp, [33] and a dramatic decrease in canine hind-leg volume as determined by mercury strain-gauge plethysmography. [38]

Where should the aorta be cross clamped?

The aorta should be cross-clamped in an intervertebral space to avoid damaging intercostal vessels. The aorta is clamped just above the diaphragm ideally but can also be clamped just below the left pulmonary hilum. After the aorta is clamped, ACLS and ATLS can continue with open cardiac massage and internal defibrillation as needed.