| Autor: |
Lodge, Frederick A., Lamberti, John J., Goodman, Allan H., Kirkpatrick, Stanley E., George, Lily, Mathewson, James W., Waldman, J. Deane |
| Zdroj: |
Journal of Thoracic and Cardiovascular Surgery; July 1983, Vol. 86 Issue: 1 p18-23, 6p |
| Abstrakt: |
The acute and chronic consequences of subclavian artery transection were analyzed in the noninvasive vascular laboratory. Twenty-eight patients (aged 1 day to 42/12 years, median 2 months) underwent subclavian artery transection (23 Blalock-Taussig, four subclavian aortoplasty for coarctation or interrupted arch, and one division of aberrant left subclavian). Bilateral systolic brachial artery pressure (BAP) was measured by Doppler instrumentation to obtain a “BAP index”: BAP1= (operated side BAP/control side BAP). Velocity waveform tracings and bilateral forearm skin temperatures were also obtained during studies before and sequentially after operation (4 hours to 12 years). Five patients underwent exercise testing of the upper extremity. Nine patients were studied for manual preference and limb development. Before operation, mean BAP, was 0.99. Immediately (4 to 48 hours) after operation, mean BAP, was 0.39. Three weeks postoperatively, BAP, was 0.62, and thereafter it remained at 0.70. All differences between preoperative, immediate postoperative and late postoperative BAP, are significant (p < 0.001). Exercise resulted in a significant (p < 0.01) increase in BAP bilaterally. Forearm skin temperature was initially lower (p < 0.01) on the operated side but approximated the control side by 1 week. Limb girth was less on the operated side (p < 0.01), without evidence of altered manual preference. In conclusion, subclavian artery transection causes permanent reduction in BAP,. The affected limb appears to respond to increased metabolic demand by increasing limb blood flow. |
| Databáze: |
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