Zusammenfassung
Der Autor stellt eine einfache technische Alternative zum Shunt nach Gott für eine passive distale Aortenperfusion während der Korrektur thorakoabdomineller Aneurysmen vor. Zur Anwendung kommen je eine Aorten- und Venenkanüle, die nach Einführung und Fixation, proximal und distal der geplanten Aortenklemmungen untereinander verbunden werden. Die Vorteile liegen im besseren Handling, in einer vorteilhafteren Hämodynamik, in einer optimalen Fixation und in einer Kostenersparnis. Die Ergebnisse der Anwendung an den ersten fünf Patienten sind zufriedenstellend und mit denen in der Literatur vergleichbar. Kein Patient verstarb, ein Patient wurde temporär dialysiert, zwei Patienten verzeichneten einen kurzzeitigen Kreatininanstieg; es gab keine neurologischen Komplikationen. Die vorläufigen Ergebnisse bestätigen die Anwendbarkeit dieser technischen Alternative; für eine endgültige Aussage bedarf es allerdings einer größeren Kasuistik.
Summary
The authors present a simple technical alternative to the Gottshunt for passive distal aortic perfusion during thoracoabdominal aneurysm surgery. The device consists of an arterial and a venous cannula as used for extracorporeal bypass. The cannulas are introduced and fixed like in cardiac surgery but proximally and distally of the planned clamping sites. Possible advantages are a better handling, a lesser hemodynamic resistance, a saver fixation of cannulas and cost saving. The preliminary results of five patients are satisfactory and comparable with these of the literature. No patient died, there was no neurologic deficit; one patient required a temporary dialysis, in two others creatinin levels raised for a short time. These preliminary results confirm the efficacy of this technical alternative; certainly there is a need of more observations for a definite statement.
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Ebner, H., Mani, G. Passive distale Aortenperfusion bei Korrektur des thorakoabdominellen Aortenaneurysmas: Technische Alternative. Z. Herz-, Thorax-, Gefäßchir. 11, 203–208 (1997). https://doi.org/10.1007/BF03042303
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DOI: https://doi.org/10.1007/BF03042303