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Ann Thorac Surg 2000;69:1748-1749
© 2000 The Society of Thoracic Surgeons

Discussion

Discussion

Dr VINCENT L. GOTT (Baltimore, MD): That was a good presentation of an intriguing approach to spinal cord protection. As you know, several of us working in William Baumgartner’s lab have been looking at retroperfusion in a swine preparation, so we have followed your work with considerable interest.

As Dr Baumgartner mentioned at the Southern Thoracic Surgical Association meeting a year ago in the discussion of a paper from your group, in our swine preparation we use left atrial-caval perfusion with cold blood. In our control group, which underwent 30 minutes of aortic cross-clamping (just beyond the subclavian artery), we found virtually no paralysis; with 45 minutes of cross-clamping, about half of the animals were paralyzed; and with 60 minutes, all of them were paralyzed. Unfortunately, using this hypothermic arterial blood shunted from the left atrium to the cava, we found no protection with 1 hour of cross-clamping, which was, of course, disappointing to us.

I was also intrigued by a paper by Follis and associates in the October 1999 issue of the Journal of Thoracic and Cardiovascular Surgery. They had a swine preparation with a straight shunt (aorta to the azygos and vena cava), and they showed no protection with 1 hour of cross-clamping in the pig. They proposed that, because of the considerable collaterals around the spinal cord, most of the blood was shunted away from it. You say you have shown barium dye in the spinal cord . . . [Full Text of this Article]






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