Management of the difficult left subclavian artery during aortic arch repair

Annals of Cardiothoracic Surgery
Ali HageCanadian Thoracic Aortic Collaborative (CTAC) Investigators

Abstract

Management of the left subclavian artery (SCA) during aortic arch surgery is associated with several challenges, including preserving distal perfusion, achieving hemostasis and preventing posterior circulation stroke and spinal cord injury. The most common challenge remains its deep position in the chest, often exacerbated by posterior and apical displacement from an arch aneurysm. We discuss several management options consisting of pre-, intra- and post-operative strategies and their respective advantages, disadvantages and clinical outcomes. A clinical algorithm is proposed to help guide decision-making in managing the difficult left SCA during aortic arch repair.

Citations

Feb 9, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ali HageMichael W A Chu
Oct 28, 2020·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Jennifer C-Y ChungIsmail El-Hamamsy
Jul 27, 2021·Journal of Cardiac Surgery·Mohamad BashirIan M Williams
Apr 27, 2020·The Journal of Thoracic and Cardiovascular Surgery·Jennifer C ChungUNKNOWN Canadian Cardiovascular Critical Care (CANCARE) Society
Jan 18, 2022·The Thoracic and Cardiovascular Surgeon·Nora GoebelUlrich F W Franke

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