Temporary shunt with distal balloon occlusion for operation on a descending aortic aneurysm

Abstract

We have used the distal balloon occlusion (DBO) technique, which is added to a temporary shunt, for operation on a descending aortic aneurysm to prevent renal failure and paraplegia. In this new technique, a balloon catheter was inserted through the femoral artery, and the balloon was inflated just above the aortic bifurcation so that the aorta was partially occluded to augment visceral and spinal perfusion during temporary shunt. From 1986 to 1989, 10 patients with a descending aortic aneurysm were operated upon using a temporary shunt. In 5 patients, the DBO technique was not employed (Group 1) and in the remaining five, it was (Group 2). In each group, there were 3 atherosclerotic and 2 dissecting aneurysms. The aortic cross-clamping time was 88±21 minutes in Group 1 and 68±29 minutes in Group 2. Group 1 had one operative death from renal failure and one instance of paraplegia. In Group 2 no patient died or had either complication. These results suggest that a temporary shunt with the DBO may be useful in operations for a descending thoracic aortic aneurysm.