RETROGRADE ABDOMINAL VISCERAL PERFUSION - IS IT BENEFICIAL

Background. It is proposed that retrograde abdominal perfusion be used in combination with retrograde cerebral perfusion to provide total bo dy visceral protection during aortic reconstruction; however, its phys iologic effects remain unknown. Methods. We compared the effect of sup erior vena caval perfusion alone with that of combined superior and in ferior vena caval perfusion on the liver and kidney in 6 mongrel dogs. Organ blood now was measured using ultrasonic flow probes on the hepa tic artery, the portal vein, and the renal artery. Regional tissue blo od now to the liver and the kidney was assessed using colored microsph eres and pH probes. Anesthetized dogs were placed on total cardiopulmo nary bypass. After cooling to 20 degrees C, retrograde perfusion was b egun with 30 minutes of superior vena caval perfusion followed by anot her 30 minutes of bicaval perfusion, or vice versa. Results. Very litt le renal blood now was measured with either method of retrograde perfu sion. Although the liver received more blood flow in comparison to the kidney, there was no significant difference between superior vena cav al perfusion alone and bicaval perfusion. The addition of inferior ven a caval perfusion results in portal hypertension, hepatic congestion, ascites, and bowel edema. Conclusions. In the canine model, bicaval pe rfusion does not provide superior protection to the liver and kidneys when compared with superior vena caval perfusion alone.