Presentation is loading. Please wait.

Presentation is loading. Please wait.

The impact of selective visceral perfusion on intestinal macrohemodynamics and microhemodynamics in a porcine model of thoracic aortic cross-clamping 

Published byCharleen Griffin Modified over 6 years ago

Similar presentations

Presentation on theme: "The impact of selective visceral perfusion on intestinal macrohemodynamics and microhemodynamics in a porcine model of thoracic aortic cross-clamping "— Presentation transcript:

1 The impact of selective visceral perfusion on intestinal macrohemodynamics and microhemodynamics in a porcine model of thoracic aortic cross-clamping  Johannes Kalder, MD, Paula Keschenau, Sebastiaan J. Hanssen, PhD, Andreas Greiner, MD, Iris C. Vermeulen Windsant, MD, Lieven N. Kennes, Rene Tolba, PhD, Fritz W. Prinzen, PhD, Wim A. Buurman, PhD, Michael J. Jacobs, PhD, Thomas A. Koeppel, MD  Journal of Vascular Surgery  Volume 56, Issue 1, Pages (July 2012) DOI: /j.jvs Copyright © 2012 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Experimental setup: A thoracolaparotomy was performed in all animals. A, Cohort I: no procedure (sham-operation); cohort II: 1 hour of thoracic aortic cross-clamping (TAC), followed by 2 hours of reperfusion. B, Cohort III: 1 hour of TAC with selective visceral perfusion (SVP), followed by 2 hours of distal aortic perfusion (DAP). Five pigs in each cohort (n = 15). CT, Celiac trunk; SMA, superior mesenteric artery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Timeline of experiments. Part 1: Thoracolaparotomy, catheter, and flow probe placement, baseline measurement. Part 2: One hour of specific procedure (cohorts I-III). Part 3: Reperfusion period (2 hours). DAP, Distal aortic perfusion; SVP, selective visceral perfusion. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Periprocedural blood pressure measurement. An intra-arterial line was placed into the right common carotid artery and the pressure was measured at T1, T4, T5 and T6 in all cohorts as well as in cohort I at T2 and T3. In cohort II, the blood pressure was measured through an intra-arterial catheter deployed in the visceral aorta. In cohort III at T2 and T3, the pressure was monitored through lines at the tip of the selective perfusion catheters. Thus, in cohort III at T2 and T3, the celiac trunk (TAC + SVP + DAP-CT) and superior mesenteric artery (TAC + SVP + DAP-SMA) were separately measured and analyzed. DAP, Distal aortic perfusion; SVP, selective visceral perfusion; T1, surgical preparation; T2, beginning of the main procedure; T3, end of the main procedure; T4, reperfusion at 15 minutes; T5, reperfusion at 60 minutes; T6, reperfusion at 120 minutes; TAC, thoracic aorta cross-clamp. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Flow rate measurements during the whole experiment were performed at the origin of the (A) celiac trunk (CT) and (B) superior mesenteric artery (SMA) vessels and at T2 and T3 in cohort III at the selective perfusion tubing system. DAP, Distal aortic perfusion; SVP, selective visceral perfusion; T1, surgical preparation; T2, beginning of the main procedure; T3, end of the main procedure; T4, reperfusion at 15 minutes; T5, reperfusion at 60 minutes; T6, reperfusion at 120 minutes; TAC, thoracic aorta cross-clamp. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Measurement of microcirculation by 15-μm fluorescent microspheres injected into the descending aorta or at T2 and T3 in cohort III directly into the extracorporeal circulation tubing system. A, Perfusion is calculated for the entire gut wall. B, The ratio between the weight-corrected emanated fluorescence between the mucosal and the muscular layer is calculated. DAP, Distal aortic perfusion; SVP, selective visceral perfusion; T1, surgical preparation; T2, beginning of the main procedure; T3, end of the main procedure; T4, reperfusion at 15 minutes; T5, reperfusion at 60 minutes; T6, reperfusion at 120 minutes; TAC, thoracic aorta cross-clamp. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

7 Fig 6 Markers for (A) aerobic oxygen extraction ratio and (B) anaerobic (lactate) metabolism were measured and calculated. The oxygen extraction ratios were calculated from arterial and portal venous blood. DAP, Distal aortic perfusion; SVP, selective visceral perfusion; T1, surgical preparation; T2, beginning of the main procedure; T3, end of the main procedure; T4, reperfusion at 15 minutes; T5, reperfusion at 60 minutes; T6, reperfusion at 120 minutes; TAC, thoracic aorta cross-clamp. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

8 Fig 7 A, Repeated pH measurements were conducted in the portal vein. B, Plasma levels (inferior cava vein) of intestinal fatty acid-binding protein (IFABP), which is a sensitive marker for intestinal small-bowel damage. DAP, Distal aortic perfusion; SVP, selective visceral perfusion; T1, surgical preparation; T2, beginning of the main procedure; T3, end of the main procedure; T4, reperfusion at 15 minutes; T5, reperfusion at 60 minutes; T6, reperfusion at 120 minutes; TAC, thoracic aorta cross-clamp. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

9 Fig 8 Hematoxylin and eosin staining of small intestinal biopsy specimens at 15 minutes of reperfusion (original magnification, ×100). Moderate tissue damage (height loss of villi) was seen in (A) sham-operated animals (cohort I) and (C) TAC + SVP + DAP animals (cohort III). B, In cohort II (TAC), extensive mucosal injury (destruction of villi and starting ulcer) was detected. DAP, Distal aortic perfusion; SVP, selective visceral perfusion; TAC, thoracic aorta cross-clamp. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Download ppt "The impact of selective visceral perfusion on intestinal macrohemodynamics and microhemodynamics in a porcine model of thoracic aortic cross-clamping "

Similar presentations

Lucy Wales, FRCS, MD, Martin Gosling, PhD, Graham W

Lucy Wales, FRCS, MD, Martin Gosling, PhD, Graham W
Department of human anatomy

Department of human anatomy
Loss of renal function and microvascular blood flow after suprarenal aortic clamping and reperfusion (SPACR) above the superior mesenteric artery is greatly.

Loss of renal function and microvascular blood flow after suprarenal aortic clamping and reperfusion (SPACR) above the superior mesenteric artery is greatly.
Regarding “A 10-year institutional experience with open branched graft reconstruction of aortic aneurysms in connective tissue disorders versus degenerative.

Regarding “A 10-year institutional experience with open branched graft reconstruction of aortic aneurysms in connective tissue disorders versus degenerative.
Bedside vena cava filter placement with intravascular ultrasound: A simple, accurate, single venous access method  Donald L. Jacobs, MD, Raghunandan L.

Bedside vena cava filter placement with intravascular ultrasound: A simple, accurate, single venous access method  Donald L. Jacobs, MD, Raghunandan L.
Therapeutic distant organ effects of regional hypothermia during mesenteric ischemia- reperfusion injury  Rachel J. Santora, MD, Mihaela L. Lie, MD, Dmitry.

Therapeutic distant organ effects of regional hypothermia during mesenteric ischemia- reperfusion injury  Rachel J. Santora, MD, Mihaela L. Lie, MD, Dmitry.
Direct thrombolytic therapy in portal and mesenteric vein thrombosis

Direct thrombolytic therapy in portal and mesenteric vein thrombosis
Central venous catheter failure is induced by injury and can be prevented by stabilizing the catheter tip  Ted R. Kohler, MD, Thomas R. Kirkman, BS  Journal.

Central venous catheter failure is induced by injury and can be prevented by stabilizing the catheter tip  Ted R. Kohler, MD, Thomas R. Kirkman, BS  Journal.
Michael Zhen-Yu Tong, MBA, MD, Pavan Koka, MD, Thomas L. Forbes, MD 

Michael Zhen-Yu Tong, MBA, MD, Pavan Koka, MD, Thomas L. Forbes, MD 
Totally videoendoscopic descending thoracic aorta-to-femoral artery bypass  Sumio Fukui, MD, Nikolaos Paraskevas, MD, Patrick Soury, MD, Frédéric Gigou,

Totally videoendoscopic descending thoracic aorta-to-femoral artery bypass  Sumio Fukui, MD, Nikolaos Paraskevas, MD, Patrick Soury, MD, Frédéric Gigou,
Celiac dissection after blunt abdominal trauma complicated by acute hepatic failure: Case report and review of literature  Chlodwig Kirchhoff, MD, Julia.

Celiac dissection after blunt abdominal trauma complicated by acute hepatic failure: Case report and review of literature  Chlodwig Kirchhoff, MD, Julia.
Selective renal blood perfusion induces renal tubules injury in a porcine model  Johannes Kalder, MD, Maria Kokozidou, DVM, MSc, PhD, Paula Keschenau,

Selective renal blood perfusion induces renal tubules injury in a porcine model  Johannes Kalder, MD, Maria Kokozidou, DVM, MSc, PhD, Paula Keschenau,
Extracorporeal circulation increases proliferation in the intestinal mucosa in a large animal model  Paula Rosalie Keschenau, MD, Stefanie Ribbe, Miriam.

Extracorporeal circulation increases proliferation in the intestinal mucosa in a large animal model  Paula Rosalie Keschenau, MD, Stefanie Ribbe, Miriam.
Fundus microvascular flow monitoring during retrograde cerebral perfusion: an experimental study  Peiqing Dong, MD, Yulong Guan, MD, Jing Yang, MD, Meiling.

Fundus microvascular flow monitoring during retrograde cerebral perfusion: an experimental study  Peiqing Dong, MD, Yulong Guan, MD, Jing Yang, MD, Meiling.
Volume 77, Issue 10, Pages (May 2010)

Volume 77, Issue 10, Pages (May 2010)
Endovascular treatment of contained rupture of a superior mesenteric artery aneurysm resulting from neurofibromatosis type I  Célio Teixeira Mendonça,

Endovascular treatment of contained rupture of a superior mesenteric artery aneurysm resulting from neurofibromatosis type I  Célio Teixeira Mendonça,
Walter J. Scott, M.D., Bruce L. Gewertz, M.D. 

Walter J. Scott, M.D., Bruce L. Gewertz, M.D. 
Reconstructive surgery for segmental arterial mediolysis involving both the internal carotid artery and visceral arteries  Hideaki Obara, MD, PhD, Kenji.

Reconstructive surgery for segmental arterial mediolysis involving both the internal carotid artery and visceral arteries  Hideaki Obara, MD, PhD, Kenji.
Johannes Kalder, MD, Dieudonne Ajah, Paula Keschenau, MD, Lieven N

Johannes Kalder, MD, Dieudonne Ajah, Paula Keschenau, MD, Lieven N
Prevention of paraplegia in pigs by selective segmental artery perfusion during aortic cross-clamping  Sven A. Meylaerts, MDa, Peter de Haan, MD, PhDb,

Prevention of paraplegia in pigs by selective segmental artery perfusion during aortic cross-clamping  Sven A. Meylaerts, MDa, Peter de Haan, MD, PhDb,

Similar presentations

Ads by Google