Intérêt de la circulation extra-corporelle femoro-femorale dans le traitement de la rupture isthmique de l'aorte thoracique

Between 1977 and 1987, eleven isthmic ruptures and three chronic posttraumatic pseudoaneurysms of the thoracic aorta have been seen in our cardiovascular surgery service. The hemorrhagic intraabdominal wounds were treated first during the same or a staged procedure. Two patients died prior to the vascular intervention. In the other cases, partial femorofemoral extracorporeal circulation has been used after systemic heparinization (3 mg/kg). The perfusion flow was approximately 2 to 3 l/min. Three patients (25%) died following operation. Only one death caused by decerebration is potentially related to heparinization. No paraplegia occurred. The partial extracorporeal circulation is a reliable method to prevent paraplegia and to diminish the left ventricular post-charge during aortic clamp time.