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2012 ; 44
(1
): P42-7
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Open aortic arch replacement: a technical odyssey
#MMPMID22730872
de la Cruz KI
; Coselli JS
; LeMaire SA
J Extra Corpor Technol
2012[Mar]; 44
(1
): P42-7
PMID22730872
show ga
Open repair of aneurysms and dissections involving the aortic arch has
traditionally been associated with high rates of morbidity and mortality,
primarily because of the complications related to the need to interrupt normal
blood flow to the cerebral circulation. Over the past several years, our approach
to these operations has gradually changed largely through the introduction of
various techniques aimed at reducing the risk of neurologic complications. Key
technical changes have included the shift from using retrograde cerebral
perfusion to using antegrade cerebral perfusion, the introduction of axillary
artery perfusion, and the change from using the patch technique to using the
Y-graft technique to reattach the brachiocephalic branches. By using this
combination of techniques, surgeons can perform aortic arch replacement with
excellent early outcomes. In this update, we summarize the evolution of our
surgical techniques and perfusion strategies for performing open repair of the
aortic arch.
|Aorta, Thoracic/*surgery
[MESH]
|Aortic Aneurysm/*surgery
[MESH]
|Brain Ischemia/*etiology/*prevention & control
[MESH]
|Extracorporeal Circulation/*methods
[MESH]
|Humans
[MESH]
|Plastic Surgery Procedures/adverse effects/*methods
[MESH]