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The Journal of Thoracic and Cardiovascular Surgery, Vol 88, 1-10, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

The arteria radicularis magna anterior as a decisive factor influencing spinal cord damage during aortic occlusion

F Wadouh, EM Lindemann, CF Arndt, R Hetzer and HG Borst

Cross-clamping of the descending aorta immediately below the subclavian artery may result in damage to the spinal cord. Despite various protective procedures, the risk of such damage cannot be entirely eliminated. In an experimental study with 47 pigs, the influence of various factors on the genesis of spinal cord damage was examined. The pigs were divided into five groups: Groups I to IV--occlusion of the descending aorta for 45 minutes; Group I--no reduction in arterial blood pressure proximal to the site of occlusion; Group II--like Group I, plus drainage of the cerebrospinal fluid; Group III--reduction in arterial blood pressure; Group IV--like Group III, plus drainage of the cerebrospinal fluid; Group V--permanent ligation of the artery of Adamkiewicz. The degree of permanent spinal cord damage was 85.7% (Groups I to IV, six animals) and 71.4% (Group V, five animals). Thus there were no significant differences among the various groups. The frequency of spinal cord damage was independent of arterial blood pressure, intracranial pressure, and intraspinal pressure. The intracranial pressure and the intraspinal pressure were significantly dependent upon the central venous pressure but were independent of the arterial blood pressure.

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