scholarly journals Aortic arch reconstruction without circulatory arrest

1999 ◽  
Vol 118 (5) ◽  
pp. 978-979 ◽  
Author(s):  
Christopher A. Caldarone ◽  
Douglas M. Behrendt
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction

Contemporary outcomes of aortic arch hypoplasia and coarctation repair in a tertiary paediatric cardiac surgery centre

2021 ◽  
pp. 1-6
Author(s):  
Amr Ashry ◽  
Amer Harky ◽  
Abdulla Tarmahomed ◽  
Christopher Ugwu ◽  
Heba M. Mohammed ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Recurrent Laryngeal Nerve Injury ◽  
Coarctation Repair ◽  
Aortic Arch Reconstruction ◽  
Retrospective Data Collection ◽  
Laryngeal Nerve Injury ◽  
Neonates And Infants ◽  
Arch Reconstruction ◽  
Aortic Arch Hypoplasia

Abstract Objectives: There are several studies reporting the outcomes of hypoplastic aortic arch and aortic coarctation repair with combination of techniques. However, only few studies reported of aortic arch and coarctation repair using a homograft patch through sternotomy and circulatory arrest with retrograde cerebral perfusion. We report our experience and outcomes of this cohort of neonates and infants. Methods: We performed retrospective data collection for all neonates and infants who underwent aortic arch reconstruction between 2015 and 2020 at our institute. Data are presented as median and inter-quartile range (IQR). Results: The cohort included 76 patients: 49 were males (64.5%). Median age at operation was 16 days (IQR 9–43.25 days). Median weight was 3.5 kg (IQR 3.10–4 kg). There was no 30 days mortality. Three patients died in hospital after 30 days (3.95%), neurological adverse events occurred in only one patient (1.32%) and recurrent laryngeal nerve injury was noted in four patients (5.26%). Only three patients required the support of extracorporeal membrane oxygenation (ECMO) with a median ECMO run of 4 days. Median follow-up was 35 months (IQR 18.9–46.4 months); 5 years survival was 93.42% (n = 71). The rate of re-intervention on the aortic arch was 9.21% (n = 7). Conclusion: Our experience shows excellent outcomes in repairing aortic arch hypoplasia with homograft patch under moderate to deep hypothermia with low in-hospital and 5 years mortality rates.

scholarly journals The analyze of neurological complications after aortic arch reconstruction in patients with proximal aortic dissection

2015 ◽  
Vol 17 (2) ◽  
pp. 35
Author(s):  
A. M. Chernyavskiy ◽  
S. A. Alsov ◽  
M. M. Lyashenko ◽  
D. A. Sirota ◽  
D. S. Khvan ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Neurological Complications ◽  
Pathological Process ◽  
Arterial Lesions ◽  
Aortic Arch Reconstruction ◽  
Almost All ◽  
Arch Reconstruction ◽  
The Brain

The article analyzes the neurological complications after interventions on the ascending aorta and the aortic arch in dissection I type by De Bakey. Group of authors investigated over a decade of experience in surgery of aortic dissection in both acute and chronic. Authors estimated the incidence of neurological complications after surgical intervention in 124 patients in the early post-operative and long term period. It were studied both qualitative measures (methods of reconstruction of the aortic arch, type of cerebral perfusion, the etiology of the pathological process, comorbidities) and quantitative (the duration of the different stages of surgery, age, height, weight). The analysis revealed that almost all cases of strokes were observed in the older age group and were associated with concomitant occlusive-stenotic arterial lesions caused by Takayasu's syndrome and atherosclerosis, as well as a set of related diseases. Increase in the number of strokes contribute to more complex, and therefore more time-consuming intervention types of reconstruction of the aortic arch. Antegrade perfusion of the brain, to our knowledge, did not have statistically significant advantages over retrograde perfusion or hypothermic circulatory arrest of the brain.

scholarly journals Low-body-perfusion via an arterial sheath reduces inflammation after aortic arch reconstruction surgery

2021 ◽  
Vol 19 ◽  
pp. 205873922110005
Author(s):  
Torsten Baehner ◽  
Johannes Breuer ◽  
Ingo Heinze ◽  
Georg Daniel Duerr ◽  
Oliver Dewald ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Kidney Injury ◽  
Tissue Perfusion ◽  
Deep Hypothermic Circulatory Arrest ◽  
Reconstruction Surgery ◽  
Aortic Arch Reconstruction ◽  
Lactate Levels ◽  
Arch Reconstruction

Pediatric cardiac surgeries involving aortic arch reconstruction are complex and require long cardiopulmonary bypass (CPB) times with deep hypothermic circulatory arrest (DHCA). Selective perfusion techniques have been developed to prevent the deleterious consequences of DHCA associated hypoperfusion. The effectivity of low body perfusion through cannulation of the femoral artery with an arterial sheath remains to be elucidated. We compared perfusion and inflammation in patients receiving selective antegrade cerebral perfusion (ACP) only to low body perfusion (LBP) in addition to ACP during DHCA for aortic arch reconstruction surgery. There was no difference in patient characteristics, cardiac pathologies, or performed procedures between ACP and LBP groups. Lactate levels increased after cardiac arrest in both groups. However, lactate levels were lower after 1 h reperfusion, at the end of extracorporeal circulation (ECC), and after surgery in LBP group compared to ACP only. Furthermore, creatinine was increased in ACP group on postoperative day 1 compared to LBP group but no acute kidney injury was observed in any group. IL-6 concentration increased in ACP group, while remained unchanged in LBP group compared to pre surgical values and were significantly lower compared to ACP group on postoperative days 1 and 2. LBP via an arterial sheath during cardiac arrest for aortic arch reconstruction surgery in addition to ACP, improves post ECC tissue perfusion as indicated by lower lactate levels and reduces creatinine levels suggesting milder kidney injury. LBP seems to prevent postoperative inflammation through a reduction in procedural duration or enhanced perfusion and thereby improves the outcome after aortic arch reconstruction surgery.

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