Successful repair of injury to posterior ascending aorta without cardiopulmonary bypass

Abstract We report the successful repair in a 29-year-old man who experienced penetration of the ascending aorta and bronchus by a crossbow bolt. Imaging studies revealed the arrow penetrating the sternum, right lung, ascending aorta and right bronchus, with mediastinal emphysema. The top of the arrow (8 mm in diameter) was deeply embedded in the body of the thoracic vertebra. The arrow was successfully removed while maintaining a stable respiratory condition by performing differential lung ventilation. There was no need for cardiopulmonary bypass. To our knowledge, this is the first case of a through-and-through penetrating ascending aorta injury.

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Cannulating a Dissecting Aorta Using Ultrasound-Epiaortic and Transesophageal Guidance

The Heart Surgery Forum ◽

10.1532/hsf98.20101170 ◽

2011 ◽

Vol 14 (6) ◽

pp. 373 ◽

Cited By ~ 4

Author(s):

Saina Attaran ◽

Maria Safar ◽

Hesham Zayed Saleh ◽

Mark Field ◽

Manoj Kuduvalli ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Aortic Dissection ◽

Acute Aortic Dissection ◽

False Lumen ◽

Type A ◽

Ascending Aorta ◽

Type A Aortic Dissection ◽

Complete Rupture

<p>Management of acute Stanford type A aortic dissection remains a major surgical challenge. Directly cannulating the ascending aorta provides a rapid establishment of cardiopulmonary bypass but consists of risks such as complete rupture of the aorta, false lumen cannulation, subsequent malperfusion and propagation of the dissection.</p><p>We describe a technique of cannulating the ascending aorta in patients with acute aortic dissection that can be performed rapidly in hemodynamically unstable patients under ultrasound-epiaortic and transesophageal (TEE) guidance.</p>

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Clinical Results of Cardiopulmonary Bypass with Selective Cerebral Perfusion for Aneurysm of the Ascending Aorta and the Aortic Arch

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(10)60905-8 ◽

1982 ◽

Vol 34 (6) ◽

pp. 659-663 ◽

Cited By ~ 10

Author(s):

Yasuhiro Soma ◽

Kozo Kawada ◽

Nobuatsu Kono ◽

Hiroji Imamura ◽

Ryohei Yotsu ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Aortic Arch ◽

Cerebral Perfusion ◽

Clinical Results ◽

Ascending Aorta ◽

Selective Cerebral Perfusion

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Intraoperative Dissection of Aorta and Successful Repair

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239800600118 ◽

1998 ◽

Vol 6 (1) ◽

pp. 66-67

Author(s):

Nainar Madhu Sankar ◽

Kevin Lai ◽

Kenneth Harrison ◽

Peter Klineberg ◽

William Meldrum Hanna

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Transesophageal Echocardiography ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Ascending Aorta ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Intraoperative Transesophageal Echocardiography ◽

Successful Repair

A 67-year-old female undergoing coronary artery bypass grafting developed dissection of the ascending aorta during decannulation. It was diagnosed by intraoperative transesophageal echocardiography and she underwent a successful repair.

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Stentless Aortic Valve Implantation through an Upper Manubrium-Limited V-Type Ministernotomy

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3181f9f6e3 ◽

2010 ◽

Vol 5 (5) ◽

pp. 378-380 ◽

Cited By ~ 6

Author(s):

Jamshid H. Karimov ◽

Alfredo Giuseppe Cerillo ◽

Tommaso Gasbarri ◽

Marco Solinas ◽

Stefano Bevilacqua ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Aortic Valve ◽

Early Experience ◽

Ascending Aorta ◽

The Novel ◽

Stentless Bioprosthesis ◽

Venous Cannula ◽

Suturing Technique ◽

Aortic Valve Implantation ◽

Valve Implantation

In this piece of work, we attempt to highlight our approach and early experience with minimally invasive aortic valve replacement with aortic Freedom Solo stentless bioprosthesis performed through an upper manubrium-limited ministernotomy in the second intercostal space. The novel suturing technique is required for stentless aortic bioprosthesis implantation, and this, in its turn, will predetermine and influence the surgeon's choice for operative access. In our department, the feasibility of the approach was first assessed; aortic valve was replaced by stentless bioprosthesis in a total of 23 patients (mean age 57 ± 12 years). In all cases, a cardiopulmonary bypass was established by a central ascending aorta cannulation and peripheral percutaneous venous cannula insertion. This approach was found to be technically reproducible and safe. The surgical technique used is described in this article.

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Anomalous Connection of Left Circumflex Artery to Pulmonary Artery

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230201000412 ◽

2002 ◽

Vol 10 (4) ◽

pp. 334-335 ◽

Cited By ~ 5

Author(s):

Seyed Hamid Mirkhani ◽

Morteza Delavarkhan ◽

Homeyra Bayat ◽

Mahdi Sanatkar

Keyword(s):

Cardiopulmonary Bypass ◽

Coronary Angiography ◽

Pulmonary Artery ◽

Chest Discomfort ◽

Circumflex Artery ◽

Left Circumflex Artery ◽

Right Pulmonary Artery ◽

The Right ◽

Successful Repair

A 52-year-old woman was evaluated for chest discomfort and dyspnea on exertion. Coronary angiography demonstrated an anomalous connection between the left circumflex artery and the right pulmonary artery. Successful repair was achieved under cardiopulmonary bypass, and the patient became completely symptom-free.

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Exceptional life threatening complication 19 years after Ravitch correction of pectus excavatum.

10.22541/au.162046982.25357609/v1 ◽

2021 ◽

Author(s):

Krzysztof Greberski ◽

Radoslaw Jarzabek ◽

Bartłomiej Perek ◽

Pawel Bugajski

Keyword(s):

Adverse Event ◽

Cardiopulmonary Bypass ◽

Pectus Excavatum ◽

Late Complication ◽

Ascending Aorta ◽

Post Discharge ◽

Postoperative Course ◽

Life Threatening ◽

Life Threatening Complication

Ravitch technique of chest correction has been considered, although invasive, as safe and efficacious surgical method. We describe a case of 35-year-old woman with cardiac tamponade and in cardiogenic shock due to exceptional late complication after pectus excavatum reconstruction by means of classic Ravitch technique 19 years earlier. This very late adverse event was caused by broken metal sternal wire that injured the wall of the ascending aorta. Patient underwent salvage repair of this segment of aorta in cardiopulmonary bypass. Postoperative course and post-discharge 3-year follow-up have been uneventful.

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Surgical approach of bentall procedure in a patient of pectus excavatum

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174973 ◽

2017 ◽

Vol 5 (11) ◽

pp. 5069

Author(s):

Subrata Pramanik ◽

Ajit Padhy ◽

Nayem Raja ◽

Subodh Satyarthy

Keyword(s):

Computed Tomography ◽

Cardiopulmonary Bypass ◽

Pectus Excavatum ◽

Ascending Aorta ◽

Sinotubular Junction ◽

Descending Aorta ◽

X Ray ◽

Severe Aortic Regurgitation ◽

Bentall Procedure ◽

Chest X Ray

A middle-aged man diagnosed case of Marfan syndrome associated with pectus excavatum presented with chest pain and dyspnea. Chest X-ray, transthoracic echocardiography and Computed tomography (CT) of heart and aorta revealed severe Aortic regurgitation with dilated aortic root, sinotubular junction and ascending aorta with normal size arch and descending aorta. Patient was taken for surgery. Pectus excavatum creates difficulties for heart exposure and cannulation for cardiopulmonary bypass. We planned for femoro-femoral bypass to carry out ahesiolysis and Bentall procedure without much difficulties. Postoperative stay of the patient was uneventful and followed up in regular interval.

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INNOMINATE ARTERY CANNULATION FOR PROXIMAL AORTIC SURGERY

10.22541/au.160898094.42392101/v1 ◽

2020 ◽

Author(s):

Bülent Mert ◽

kamil boyacıoğlu ◽

Hakan Sacli ◽

Berk Özkaynak ◽

Ibrahim Kara ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Cerebral Perfusion ◽

Circulatory Arrest ◽

Aortic Surgery ◽

Innominate Artery ◽

Arterial Injury ◽

Ascending Aorta ◽

Artery Cannulation ◽

The Mean ◽

Antegrade Cerebral Perfusion

Background. The aim of this study was to evaluate the efficacy and safety of innominate artery cannulation strategy with side graft technique in proximal aortic pathologies. Methods. A total of 70 patients underwent innominate artery cannulation with a side graft for surgery on the proximal aorta from 2012 to 2020. There were 46 men and 24 women with an avarage age of 56 ±13 years. The indications of surgery were type A aortic dissection in 17 patients (24.3%), aortic aneurysm in 52 patients (74.3%) and ascending aorta pseudoaneurysm in 1 patient (1.4%). The innominate artery was free of disease in all patients. Hypothermic circulatory arrest with antegrade cerebral perfusion was utilized in 60 patients (85.7%). 3 patients had previous sternotomy (4.2%). The most common surgical procedure was ascending aorta and hemiarch replacement in 34 patients (48.5%). Results. The mean cardiac ischemia and cardiopulmonary bypass times were 116+46 minutes and164+56 minutes, respectively. The mean antegrade cerebral perfusion time was 27+14 minutes. The patients were cooled between 22’C and 30’C during surgery. 30-day mortality rate was 7.1% with 5 patients. 1 patient (1.4%) had stroke, 1 patient (1.4%) had temporary neurologic deficit and 8 patients (11.4%) had confusion and agitation that resolved completely in all cases. There was no local complication or arterial injury was encounterd. Conclusions. Cannulation of the innominate artery with side graft is safe and effective for both cardiopulmonary bypass and antegrade cerebral perfusion. This technique provides excellent neurologic outcomes for proximal aortic surgery.

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