Aortic arch surgery using moderate systemic hypothermia and antegrade cerebral perfusion via the right subclavian artery

The Thoracic and Cardiovascular Surgeon
H AebertD E Birnbaum

Abstract

Surgery of the aortic arch avoiding profound systemic hypothermia and using antegrade or retrograde cerebral perfusion has recently been popularized. This usually renders the CPB and surgical field set-up more complex. We propose a simple method achieving a similar effect. During a 6-month period, 7 patients (median age 72 years) underwent surgery involving the aortic arch with cannulation of the right subclavian artery for arterial return. There were 6 acute type A dissections and one ascending aorta and arch aneurysm. After commencing CPB, the ascending aorta was clamped and reconstruction of aortic valve and root were initiated. Patients were cooled to a tympanic temperature of 25 - 27 degrees C. CPB was then stopped, and the arch was opened and inspected from inside. While resuming arterial perfusion via the right subclavian artery, the arch branches were clamped sequentially from right to left under observation for back flow. Bilateral radial artery pressure and temporal transcutaneous oxygen saturation were always monitored. In all cases, the aortic valve was spared using remodeling and resuspension techniques. 2 complete arch, 2 partial arch and 3 proximal arch replacements were performed. Mean times were 183 (113 - 321)...Continue Reading

Citations

May 7, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Paul P UrbanskiAnno Diegeler
Jun 24, 2004·Artificial Organs·David JeggerLudwig K von Segesser
Dec 5, 2006·The Journal of Thoracic and Cardiovascular Surgery·Paul P UrbanskiAnno Diegeler
Nov 21, 2002·The Annals of Thoracic Surgery·David SpielvogelRandall B Griepp
Feb 20, 2007·The Annals of Thoracic Surgery·Helmut GulbinsJürgen Ennker
Jul 13, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Zongli RenWanli Jiang

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Aortic Aneurysm

An aortic aneurysm is the weakening and bulging of the blood vessel wall in the aorta. This causes dilatation of the aorta, which is usually asymptomatic but carries the risk of rupture and hemorrhage. Find the latest research on aortic aneurysms here.

Cardiac Aneurysm

Aneurysm refers to a bulge of the wall or lining of a vessel commonly occurring in the blood vessels at the base of the septum or within the aorta. In the heart, it usually arises from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood. Discover the latest research on cardiac aneurysm here.

Related Papers

The Journal of Thoracic and Cardiovascular Surgery
Nasim HedayatiAlan H Markowitz
The Journal of Thoracic and Cardiovascular Surgery
C K Rokkas, N T Kouchoukos
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Kazumasa OrihashiKatsuhiko Imai
© 2021 Meta ULC. All rights reserved