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Hemodynamic Effects of Aortic Occlusion

  • Branko Furst
Chapter

Abstract

Mechanical occlusion of the aorta is characterized by a complex hemodynamic response and is of great interest not only to cardiovascular physiologists but also to clinicians in the fields of vascular surgery and anesthesia. Should the heart function as a pressure-propulsion pump, occlusion of the thoracic aorta would result in a profound decrease in venous return. The opposite, however, is the case. Experimental occlusion of thoracic aorta in controlled experiments results in a marked increase in arterial pressure, 20–40% increase in cardiac output and in super-perfusion of the vascular compartments above the occlusion. Mobilization of blood from the splanchnic reservoir is an attempt to correct a profound imbalance between the under-perfused regions below, and super-perfused regions above the aortic occlusion, and indicates a relative independence of the arterial and venous limbs of the circuit. Adaptation of the heart to increased hemodynamic load of aortic occlusion unmasks its hydraulic ram-like function. In addition to hemodynamic perturbations, aortic occlusion results in several neuro-hormonal, acid–base, and rheological adjustments. Paradoxical decrease of oxygen consumption, also in organs above the occlusion, indicates a systemic response. The accumulation and release of cardiodepressant and vasoactive metabolites from ischemic tissues leads to reactive hyperemia and a profound drop in pressure following the release of occlusion.

Keywords

Aortic occlusion Cardiac output during aortic occlusion The role of venous reservoir and of peripheral circulation Hemodynamics of aortic occlusion Cardiac effects of aortic occlusion Proximal and distal aortic occlusion Suprarenal and infrarenal aortic occlusion 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Branko Furst
    • 1
  1. 1.Professor of AnesthesiologyAlbany Medical CollegeAlbanyUSA

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