Open Distal Anastomosis Technique for Ascending Aortic Aneurysm Repair without Cerebral Perfusion

2015 ◽  
Vol 18 (4) ◽  
pp. 124
Author(s):  
Mehmet Kaplan ◽  
Bahar Temur ◽  
Tolga Can ◽  
Gunseli Abay ◽  
Adlan Olsun ◽  
...  

<p><strong>Background</strong><strong>: </strong>This study aimed to report the outcomes of patients who underwent proximal thoracic aortic aneurysm surgery with open distal anastomosis technique but without cerebral perfusion, instead under deep hypothermic circulatory arrest.</p><p><strong>Methods: </strong>Thirty patients (21 male, 9 female) who underwent ascending aortic aneurysm repair with open distal anastomosis technique were included. The average age was 60.2±11.7 years. Operations were performed under deep hypothermic circulatory arrest and the cannulation for cardiopulmonary bypass was first done over the aneurysmatic segment and then moved over the graft. Intraoperative and early postoperative mortality and morbidity outcomes were reported.</p><p><strong>Results</strong><strong>: </strong>Average duration of cardiopulmonary bypass and cross-clamps were 210.8±43 and 154.9±35.4 minutes, respectively. Average duration of total circulatory arrest was 25.2±2.4 minutes. There was one hospital death (3.3%) due to chronic obstructive pulmonary disease at postoperative day 22. No neurological dysfunction was observed during the postoperative period.<strong></strong></p><p><strong>Conclusion: </strong>These results demonstrate that open distal anastomosis under less than 30 minutes of deep hypothermic circulatory arrest without antegrade or retrograde cerebral perfusion and cannulation of the aneurysmatic segment is a safe and reliable procedure in patients undergoing proximal thoracic aortic aneurysm surgery.</p><p> </p>

2018 ◽  
Vol 45 (2) ◽  
pp. 70-75 ◽  
Author(s):  
Prity Gupta ◽  
Amer Harky ◽  
Saleem Jahangeer ◽  
Benjamin Adams ◽  
Mohamad Bashir

Cardiovascular surgeons have long debated the safe duration of deep hypothermic circulatory arrest during thoracic aortic aneurysm surgery. The rationale for using adjunctive cerebral perfusion (or not) is to achieve the best technical aortic repair with the lowest risk of morbidity and death. In this literature review, we highlight the debates surrounding these issues, evaluate the disparate findings on deep hypothermic circulatory arrest durations and temperatures, and consider the usefulness of adjunctive perfusion.


2017 ◽  
Vol 6 (1) ◽  
pp. 39-43
Author(s):  
Jeju Nath Pokharel ◽  
MR Upreti ◽  
DR Shakya ◽  
Bhagwan Koirala ◽  
Jyotindra Sharma ◽  
...  

A 46 years female underwent aortic arch repair surgery under deep hypothermic circulatory arrest (DHCA) and right antegrade cerebral perfusion. The patient was extubnated after 13 hours of the surgery and discharged from SICU on third post operative day and discharged from hospital on sixth postoperative day uneventfully and with excellent neurological functions. It was the first case of aortic arch repair in our hospital. Combination of DHCA and right antegrade cerebral perfusion may be the reason for better neurological outcome.


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