Left atrial-inferior vena cava bypass achieves retroperfusion of the porcine spinal cord: Morphologic and preliminary physiologic studies

John R. Doty, Peter L. Walinsky, Jorge D. Salazar, Jeffrey Brawn, Melissa Haggerty, J. Mark Redmond, William A Baumgartner, Vincent L Gott

Research output: Contribution to journalArticle

Abstract

Background. Spinal cord injury remains a devastating complication after procedures on the descending thoracic aorta. A new model for retrograde perfusion of the spinal cord during aortic cross-clamping was evaluated for its potential role in preventing spinal cord injury after thoraco-abdominal aortic surgery. Methods. Retrograde perfusion of the spinal cord was established in juvenile pigs using partial bypass from the left atrium to the isolated inferior vena cava. Flow was maintained for a 60-min period of aortic occlusion. Morphologic studies of spinal cord blood flow were obtained using injection of a dilute barium-gelatin-chromatin dye solution. Physiologic cooling of the spinal cord was achieved using varying degrees of hypothermic retroperfusion. Results. Five animals underwent a 30-min period of retroperfusion followed by dye injection. Dye was identified in spinal cord venules and capillaries, most heavily concentrated in the lumbar and lower thoracic cord. Thirteen animals underwent a 60-min period of normothermic (37°C), mild hypothermic (27°C), moderate hypothermic (17°C), or deep hypothermic (7°C) retroperfusion; mean spinal cord temperatures were 35.2, 32.2, 28.0, and 24.4°C, respectively. Conclusions. Retrograde perfusion of the porcine spinal cord using a left atrial to inferior vena cava partial bypass circuit can be accomplished and can be used with hypothermic perfusate to produce cooling of the spinal cord. This new technique warrants further investigation into spinal cord protection and potential application for operations on the descending thoracic aorta.

Original languageEnglish (US)
Pages (from-to)157-164
Number of pages8
JournalJournal of Surgical Research
Volume108
Issue number1
DOIs
StatePublished - 2002

Fingerprint

Inferior Vena Cava
Spinal Cord
Swine
Thoracic Aorta
Coloring Agents
Perfusion
Spinal Cord Injuries
Injections
Venules
Barium
Gelatin
Heart Atria
Fetal Blood
Constriction
Chromatin
Temperature

Keywords

  • Aneurysm
  • Perfusion
  • Spinal cord
  • Thoracoabdominal

ASJC Scopus subject areas

  • Surgery

Cite this

Left atrial-inferior vena cava bypass achieves retroperfusion of the porcine spinal cord : Morphologic and preliminary physiologic studies. / Doty, John R.; Walinsky, Peter L.; Salazar, Jorge D.; Brawn, Jeffrey; Haggerty, Melissa; Redmond, J. Mark; Baumgartner, William A; Gott, Vincent L.

In: Journal of Surgical Research, Vol. 108, No. 1, 2002, p. 157-164.

Research output: Contribution to journalArticle

Doty, John R. ; Walinsky, Peter L. ; Salazar, Jorge D. ; Brawn, Jeffrey ; Haggerty, Melissa ; Redmond, J. Mark ; Baumgartner, William A ; Gott, Vincent L. / Left atrial-inferior vena cava bypass achieves retroperfusion of the porcine spinal cord : Morphologic and preliminary physiologic studies. In: Journal of Surgical Research. 2002 ; Vol. 108, No. 1. pp. 157-164.
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abstract = "Background. Spinal cord injury remains a devastating complication after procedures on the descending thoracic aorta. A new model for retrograde perfusion of the spinal cord during aortic cross-clamping was evaluated for its potential role in preventing spinal cord injury after thoraco-abdominal aortic surgery. Methods. Retrograde perfusion of the spinal cord was established in juvenile pigs using partial bypass from the left atrium to the isolated inferior vena cava. Flow was maintained for a 60-min period of aortic occlusion. Morphologic studies of spinal cord blood flow were obtained using injection of a dilute barium-gelatin-chromatin dye solution. Physiologic cooling of the spinal cord was achieved using varying degrees of hypothermic retroperfusion. Results. Five animals underwent a 30-min period of retroperfusion followed by dye injection. Dye was identified in spinal cord venules and capillaries, most heavily concentrated in the lumbar and lower thoracic cord. Thirteen animals underwent a 60-min period of normothermic (37°C), mild hypothermic (27°C), moderate hypothermic (17°C), or deep hypothermic (7°C) retroperfusion; mean spinal cord temperatures were 35.2, 32.2, 28.0, and 24.4°C, respectively. Conclusions. Retrograde perfusion of the porcine spinal cord using a left atrial to inferior vena cava partial bypass circuit can be accomplished and can be used with hypothermic perfusate to produce cooling of the spinal cord. This new technique warrants further investigation into spinal cord protection and potential application for operations on the descending thoracic aorta.",
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AU - Walinsky, Peter L.

AU - Salazar, Jorge D.

AU - Brawn, Jeffrey

AU - Haggerty, Melissa

AU - Redmond, J. Mark

AU - Baumgartner, William A

AU - Gott, Vincent L

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N2 - Background. Spinal cord injury remains a devastating complication after procedures on the descending thoracic aorta. A new model for retrograde perfusion of the spinal cord during aortic cross-clamping was evaluated for its potential role in preventing spinal cord injury after thoraco-abdominal aortic surgery. Methods. Retrograde perfusion of the spinal cord was established in juvenile pigs using partial bypass from the left atrium to the isolated inferior vena cava. Flow was maintained for a 60-min period of aortic occlusion. Morphologic studies of spinal cord blood flow were obtained using injection of a dilute barium-gelatin-chromatin dye solution. Physiologic cooling of the spinal cord was achieved using varying degrees of hypothermic retroperfusion. Results. Five animals underwent a 30-min period of retroperfusion followed by dye injection. Dye was identified in spinal cord venules and capillaries, most heavily concentrated in the lumbar and lower thoracic cord. Thirteen animals underwent a 60-min period of normothermic (37°C), mild hypothermic (27°C), moderate hypothermic (17°C), or deep hypothermic (7°C) retroperfusion; mean spinal cord temperatures were 35.2, 32.2, 28.0, and 24.4°C, respectively. Conclusions. Retrograde perfusion of the porcine spinal cord using a left atrial to inferior vena cava partial bypass circuit can be accomplished and can be used with hypothermic perfusate to produce cooling of the spinal cord. This new technique warrants further investigation into spinal cord protection and potential application for operations on the descending thoracic aorta.

AB - Background. Spinal cord injury remains a devastating complication after procedures on the descending thoracic aorta. A new model for retrograde perfusion of the spinal cord during aortic cross-clamping was evaluated for its potential role in preventing spinal cord injury after thoraco-abdominal aortic surgery. Methods. Retrograde perfusion of the spinal cord was established in juvenile pigs using partial bypass from the left atrium to the isolated inferior vena cava. Flow was maintained for a 60-min period of aortic occlusion. Morphologic studies of spinal cord blood flow were obtained using injection of a dilute barium-gelatin-chromatin dye solution. Physiologic cooling of the spinal cord was achieved using varying degrees of hypothermic retroperfusion. Results. Five animals underwent a 30-min period of retroperfusion followed by dye injection. Dye was identified in spinal cord venules and capillaries, most heavily concentrated in the lumbar and lower thoracic cord. Thirteen animals underwent a 60-min period of normothermic (37°C), mild hypothermic (27°C), moderate hypothermic (17°C), or deep hypothermic (7°C) retroperfusion; mean spinal cord temperatures were 35.2, 32.2, 28.0, and 24.4°C, respectively. Conclusions. Retrograde perfusion of the porcine spinal cord using a left atrial to inferior vena cava partial bypass circuit can be accomplished and can be used with hypothermic perfusate to produce cooling of the spinal cord. This new technique warrants further investigation into spinal cord protection and potential application for operations on the descending thoracic aorta.

KW - Aneurysm

KW - Perfusion

KW - Spinal cord

KW - Thoracoabdominal

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