体外循環中の冠遮断の末梢血管抵抗におよぼす影響

The effect of myocardial ischemia by aortic the peripheralvascular resistance during clamping on cardiopulmonary bypass

　開心術時には，心内操作を容易ならしめるため，大動脈を起始部で遮断して冠血流を停止させ，無血術野をうる方法，いわゆる冠遮断が行われる。冠遮断は複雑な心奇形に対する根治術，人工弁置換術などの増加とともに頻繁に行われるようになった。

　冠遮断は従来より主に心筋保護の観点より検討されている。それが，体外循環中の末梢循環におよぼす影響についての検討は少ない^1,2）。今回われわれは，体外循環時の冠遮断が末梢循環におよぼす影響を臨床例で検討した。

We studied the effect of myocardial ischemia on the peripheral circulation by aortic clamping during cardiopulmonary bypass, whereas ischemic cardiac arrest has been much debated from theviewpoint of myocardial protection especially in cardiac surgery.

The vascular resistance of superior vena cava (SVC) and inferior vena cava (IVC) areas were measured with pressure transducers and an electromagnetic flowmeter in 87 patients during cardiopulmonary bypass. In 15 patients, the arterial perfusion and venous drainage states were kept constant without any manipulation of the heart lung machine during aortic clamping and declamping.