The pathophysiology of aortic cross-clamping

Zammert, Martin; Gelman, Simon

doi:10.1016/j.bpa.2016.07.006

Cited by 56 publications

(44 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Experimental data on changes in systolic volume during clamping are available from several small-sized clinical observational studies in adult patients undergoing cardiovascular surgeries. However, some data suggest that systolic volume decreases ( [12], [9], [7]), while others suggest that it stays the same ( [13], [11], [3]). These inconsistent findings are possibly due to differences in loading conditions, surgery techniques, and patient comorbidities [3].…”

Section: Discussionmentioning

confidence: 99%

“…However, some data suggest that systolic volume decreases ( [12], [9], [7]), while others suggest that it stays the same ( [13], [11], [3]). These inconsistent findings are possibly due to differences in loading conditions, surgery techniques, and patient comorbidities [3]. A second reason to support our assumption of a constant systolic volume is that, since we are interested in studying only the immediate impact of clamping, changes in systolic volume during this short time frame, if any, could be considered as non-significant.…”

Section: Discussionmentioning

confidence: 99%

“…Clamping consists of an external compression of the artery to prevent blood from flowing downstream, thus providing a more stable operative field. This procedure produces perturbations in cardiovascular hemodynamics ( [3], [4]) but the exact mechanisms involved are not completely clear.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Parameter estimation to study the immediate impact of aortic cross‐clamping using reduced order models

Ventre

Politi

Fernández

et al. 2019

Numer Methods Biomed Eng

View full text Add to dashboard Cite

Aortic cross‐clamping is a common strategy during vascular surgery, however, its instantaneous impact on hemodynamics is unknown. We, therefore, developed two numerical models to estimate the immediate impact of aortic clamping on the vascular properties. To assess the validity of the models, we recorded continuous invasive pressure signals during abdominal aneurysm repair surgery, immediately before and after clamping. The first model is a zero‐dimensional (0D) three‐element Windkessel model, which we coupled to a gradient‐based parameter estimation algorithm to identify patient‐specific parameters such as vascular resistance and compliance. We found a 10% increase in the total resistance and a 20% decrease in the total compliance after clamping. The second model is a nine‐artery network corresponding to an average human body in which we solved the one‐dimensional (1D) blood flow equations. With a similar parameter estimation method and using the results from the 0D model, we identified the resistance boundary conditions of the 1D network. Determining the patient‐specific total resistance and the distribution of peripheral resistances through the parameter estimation process was sufficient for the 1D model to accurately reproduce the impact of clamping on the pressure waveform. Both models gave an accurate description of the pressure wave and had a high correlation (R2 > .95) with experimental blood pressure data.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Parameter estimation to study the immediate impact of aortic cross‐clamping using reduced order models

Ventre

Politi

Fernández

et al. 2019

Numer Methods Biomed Eng

View full text Add to dashboard Cite

show abstract

“…As noted in the anecdotal reports, surgical intervention is generally effective in resection of the aneurysm and prevention of late complications including rupture. In addition to the usual anesthetic concerns involved with AAA resection, preoperative identification and optimization of end-organ involvement of TSC may facilitate the perioperative care of these patients [30][31][32]. Table 1…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management of Abdominal Aortic Aneurysm Repair in a Patient With Tuberous Sclerosis Complex

et al. 2019

View full text Add to dashboard Cite

Tuberous sclerosis complex, also known as Bourneville disease, is an autosomal dominant, progressive neurocutaneous disorder with variable presentation and multisystem involvement. It is characterized by the development of benign tumors in multiple organs and tissues in the body, with the majority of patients having neurological involvement. We report a 19-year-old adolescent, with tuberous sclerosis and advanced systemic involvement of the disease, presenting for surgical repair of an abdominal aortic aneurysm. The etiology and presentation of TS are discussed and its multisystem organ involvement is reviewed with emphasis on the anesthetic implications of the disease.

show abstract

“…Generally speaking, the higher the location of the aortic clamp, the greater the increase of the afterload against which the heart has to work [58]. The immediate effect of aortic clamping is a rapid increase of blood pressure due to an increase in systemic vascular resistance (SVR) [58,59] (Fig. 14.1).…”

Section: Hemodynamic Response To Cross-clampingmentioning

confidence: 99%

Physiopathology of Intraoperative Visceral Ischemia and Anesthesiological Management of Supravisceral Aortic Clamping

Monaco

Barucco

Mattioli

et al. 2019

Visceral Vessels and Aortic Repair

View full text Add to dashboard Cite

The pathophysiology of aortic cross-clamping

Cited by 56 publications

References 73 publications

Parameter estimation to study the immediate impact of aortic cross‐clamping using reduced order models

Parameter estimation to study the immediate impact of aortic cross‐clamping using reduced order models

Anesthetic Management of Abdominal Aortic Aneurysm Repair in a Patient With Tuberous Sclerosis Complex

Physiopathology of Intraoperative Visceral Ischemia and Anesthesiological Management of Supravisceral Aortic Clamping

Contact Info

Product

Resources

About