PRESERVATION OF VISCERAL PERFUSION DURING RESECTION OF THORACOABDOMINAL ANEURYSM.

When renal failure complicates postoperative recovery in any operative procedure, the mortality is expected to double. To avoid this complication, a technique was devised to preserve renal perfusion during resection of a thoracoabdominal aneurysm. With systemic heparinization, an extravascular shunt is placed between the descending aorta and the visceral branches; any blood loss is recovered by autotransfusion. After completion of the operation and reversal of heparinization, the normal clotting mechanism is restored by terminal reinfusion of 2 units of autogenous blood that had been collected and stored before heparinization.