Intraoperative video showing the sequence of the operation highlighting the removal of the stent and infected material and further reconstruction of the aortic arch, proximal descending thoracic aorta and supra-aortic trunks using a Thoraflex PlexusTM (Terumo Aortic, Vascutek) with cardiopulmonary bypass, moderate hypothermic circulatory arrest and antegrade cerebral perfusion.

ASVIDE ◽  
2021 ◽  
Vol 8 ◽  
pp. 367-367
Author(s):  
Ana Lopez-Marco ◽  
Saleem Jahangeer ◽  
Benjamin Adams ◽  
Aung Ye Oo
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Descending Thoracic Aorta ◽  
Infected Material ◽  
Antegrade Cerebral Perfusion

scholarly journals Hypothermic circulatory arrest with or without antegrade cerebral perfusion for aortic arch surgery in infants

2019 ◽  
Vol 1 (3) ◽  
pp. 99-104
Author(s):  
Mohamed Abdel Fouly
Keyword(s):  
Cerebral Infarction ◽  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Aortic Arch Surgery ◽  
Significant Difference ◽  
Arch Reconstruction ◽  
Antegrade Cerebral Perfusion

Background: Antegrade cerebral perfusion (ACP) minimizes deep hypothermic circulatory arrest (DHCA) duration during arch surgery in infants, which may impact the outcomes of the repair. We aimed to evaluate the effect of adding antegrade cerebral perfusion to deep hypothermic circulatory arrest on DHCA duration and operative outcomes of different aortic arch operations in infants. Methods: We retrospectively collected data from infants (<20 weeks old) who underwent aortic arch reconstruction (Norwood operation, arch reconstruction for the hypoplastic arch and interrupted aortic arch) using DHCA alone (n=88) or combined with ACP (n=26). We excluded patients who had concomitant procedures and those with preoperative neurological disability. Results: There was no difference between groups as regards the age, gender, and the operation performed (p= 0.64; 0.87 and 0.50; respectively). Among the 114 patients, 11 (9.6%) had operative mortality, and 14 (12.3%) had cerebral infarction diagnosed with CT scanning. Adding ACP to DHCA significantly reduced DHCA duration from 50.7 ± 10.6 minutes to 22.4 ± 6.2 minutes (p<0.001) and lowered the mortality (11 vs. 0; p=0.066) and cerebral infarction (13 vs. 1; p=0.18). No statistically significant difference between the two groups in terms of ischemic time (p=0.63) or hospital stay duration (p=0.47). Conclusion: Using ACP appears to reduce the DHCA duration and was associated with better survival and neurological outcomes of aortic arch surgery in infants. A study with longer follow-up to evaluate the long-term neurological sequelae is recommended.

scholarly journals Aortic Arch Aneurysm Repair under Deep Hypothermic Circulatory Arrest

2017 ◽  
Vol 6 (1) ◽  
pp. 39-43
Author(s):  
Jeju Nath Pokharel ◽  
MR Upreti ◽  
DR Shakya ◽  
Bhagwan Koirala ◽  
Jyotindra Sharma ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
First Case ◽  
Aortic Arch Repair ◽  
Aneurysm Repair ◽  
Arch Aneurysm ◽  
Antegrade Cerebral Perfusion

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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