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Experimental unassisted right brachial-to-femoral bypass. An adjuvant during aortic cross-clamping.

This study was devised to investigate the efficacy of the simplest possible shunt in the prevention of difficulties resulting from thoracic aortic cross-clamping, utilizing peripheral arteries without pump or general heparinization. Controls subjected to one hour's double aortic clamping (just beyond the origin of the subclavian artery and just above the diaphragm) were all paraplegic, each showed an early rise in blood urea nitrogen (BUN) level, and none survived. In contrast, either a polyethylene tube shunt from the right brachial artery in the antecubital fossa to the common femoral artery or one constructed by suturing a Dacron graft to incisions at these sites prevented death, substantial rise in BUN level, and paraplegia. Free unassisted right brachial-to-femoral shunts in the dog appear to offer good protection against double clamping of the thoracic aorta for an hour.