An aortic cross-clamp is a
surgical instrument
A surgical instrument is a tool or device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of ...
used in
cardiac surgery
Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to corr ...
to clamp the
aorta
The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ...
and separate the
systemic circulation
The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
from the outflow of the
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
.
An aortic cross-clamping procedure serves, for example, in the repairing of
coarctation of the aorta. In newborns, the treatment of choice for this condition is resection and primary
anastomosis
An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf#Veins, leaf veins, or streams. Such a connection m ...
. The clamping of the aorta excludes the systemic circulation, by definition, thus causing an ischemia. When a long cross-clamping period (longer than 25 min) or a drop in distal aortic pressure below 50–60 mmHg is anticipated, the use of an intraoperative shunt may prevent complications such as
paraplegia
Paraplegia, or paraparesis, is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek ()
"half-stricken". It is usually caused by spinal cord injury or a congenital condition that affects the neural ...
.
[Schwartz's principles of surgery: self assessment and board review, 8th edition, chapter 19 question 5, chapter 21 question 17]
References
Medical clamps
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