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Ann Thorac Surg 1989;47:890-896
© 1989 The Society of Thoracic Surgeons
Second Department of Surgery, National Defense Medical College, Saitama, Japan
Accepted for publication December 30, 1988.
* Address reprint requests to Dr Masuda, 3-2 Tokorozawa, Saitama, 359, Japan.
To evaluate the physiological changes that occur after temporary occlusion of the superior vena cava, we clamped the vena cava for one hour in 6 cynomolgus monkeys, monkeys with a venous system most resembling that of humans. The data from arterial blood gas analysis, ie, pH, arterial oxygen tension, arterial carbon dioxide tension, and HCO3 –, were within normal limits during and after occlusion of the superior vena cava. Intracranial pressure was 8.6 ± 0.8 mm Hg (mean ± standard error) before occlusion and rose to 22.1 ± 2.2 mm Hg during clamping. It decreased significanity to 17.7 ± 1.9 mm Hg just before removal of the clamp and recovered to 8.6 ± 0.9 mm Hg after the clamp was removed. Regional cerebral blood flow was 45 ± 9 mL/min/100 g before clamping and decreased to 37 ± 3 mL/min/100 g during clamping. It recovered to 47 ± 5 mL/min/100 g after removal of the clamp. Cerebral perfusion pressure was within the margin of safety during clamping. Histological findings in the brain showed the effect of congestion in 1 monkey, but the change was slight. The electroencephalogram and electrocardiogram showed no abnormalities in this experiment. In conclusion, one-hour clamping of the superior vena cava with the azygos vein ligated was safe in 6 cynomolgus monkeys. We believe that in the clinical setting, one-hour occlusion of the superior vena cava would result in findings similar to those in this study, unless particular complications, such as arteriosclerosis or a cerebrovascular disorder, exist.
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