[Clamping of the thoracic aorta in a hypertensive patient with coronary disease. An indication of sodium nitroprusside (author's transl)]

In patients with cardiac failure, coronary disease or arterial hypertension, clamping of the aorta results in increased filling pressure of the left ventricle which may produce or increase subendocardial ischaemia with consequent aggravation of the ventricular insufficiency. And the higher the clamping the greater the risk. This vicious circle can be broken by sodium nitroprusside, which has potent and reversible vasodilator properties. The drug is indicated whenever the left ventricular filling pressure rises above 5 mmHg. These considerations are illustrated by the descriptions of a case where sodium nitroprusside ensured blood circulation in the lower limbs and intra-abdominal organs after clamping of the aorta above the coeliac artery in a high risk cardiac patient.