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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 787-794, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
F Wadouh, CF Arndt, H Metzger, M Hartmann, R Wadouh and HG Borst
Spinal cord injury is the most dreaded complication of operative procedures
on the descending aorta. Our previous experimental study on pigs indicated
that an increase in the cerebrospinal fluid pressure after aortic
cross-clamping did not influence the occurrence of spinal cord injury. We
therefore concluded that the cause of spinal cord injury after aortic
cross-clamping is due to primary oxygen deficiency in the spinal cord
distal to the occlusion site, especially in the area supplied by the artery
of Adamkiewicz. The aim of the present study is to examine the primary
ischemic cause of spinal cord injury after aortic cross-clamping by
directly measuring the oxygen tension on the spinal cord surface in pigs.
During the occlusion phase, oxygen tension decreased significantly distal
to the clamping site and especially in the areas supplied by the artery of
Adamkiewicz both after occlusion of the high thoracic (Group I) and the
lumbar aorta (Group II). The marked decrease in oxygen tension proves that
hypoxia is the primary reason for spinal cord injury. The presence of a
"steal phenomenon" should be discussed.
ARTICLES
Direct measurements of oxygen tension on the spinal cord surface of pigs after occlusion of the descending aorta
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