Abstract
The effect of the pexis between kidney and the spleen or omentum upon the blood pressure of dogs rendered hypertensive by Goldblatt's 1 method of renal constriction has been studied in this laboratory since 1936. Sixty-five dogs have been employed in the development of 2 suitable technics for establishing organ pexis to such ischemic kidneys. Seven animals survived the various surgical procedures for producing carotid loop, 2 hypertension 1 and the union of the organs.
Only 2 died as the result of the latter operation. Fifty-six dogs died or were discarded because of hemorrhage from the carotid loop employed for blood pressure determination, anesthetic deaths, uremia from infarction of the kidneys, distemper, and operative infection. Postoperative shock was insignificant following the pexis which was performed one to 3 months after the hypertension was established. Control operations in which the omentum and spleen were manipulated did not result in a significant prolonged fall in blood pressure.
The blood pressure of all of the 7 animals was lowered within 4 days following the union. Three of these, following the pexis of encapsulated renal surface with omentum, had temporary reversal of hypertension lasting 6-38 days. (Table I.) The other 4 animals in which the longitudinal cut surface of the spleen was attached to the renal surface or imbedded (Animals Nos. 95 and 116) in an incision through the long axis of the kidney down to the pelvis, showed a continuous decline in blood pressure toward normal, persisting S weeks to 6 months. (Table I.)
To verify the existence of a collateral circulation, India ink was injected into the splenic artery of an excised preparation consisting of an adherent kidney and spleen.
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