Technique and rationale for branch-first total aortic arch repair
| Autor: | Michelle Kim, George Matalanis |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic arch medicine.medical_specialty total aortic arch repair medicine.medical_treatment TAPP trifurcation arch graft with side perfusion port branch-first Port (medical) LCCA left common carotid artery medicine.artery Ascending aorta medicine antegrade cerebral perfusion Embolization Cerebral perfusion pressure Adult: Aorta IA innominate artery Aorta business.industry Surgery aortic arch replacement Circulatory system cardiovascular system business LSCA left subclavian artery Perfusion |
| Zdroj: | JTCVS Techniques |
| ISSN: | 2666-2507 |
| DOI: | 10.1016/j.xjtc.2020.09.014 |
| Popis: | Objective Our objective was to describe the technique and rationale for branch-first total aortic arch repair. Methods Branch-first total aortic arch repair involves serial clamping, reconstruction, and reperfusion of each of the arch branches using a specially designed trifurcation graft with a side port. During this sequence, perfusion to the heart and distal organs are preserved and continuous antegrade cerebral perfusion is permitted via the trifurcation graft. The diseased aorta is excised and replaced with a Dacron graft (W.L. Gore and Associates, Newark, Del) with a perfusion side port. The trifurcation graft is anastomosed to the new proximal ascending aorta. Results The branch-first technique permits total aortic arch repair without global cerebral circulatory arrest and excessive hypothermia. It shortens distal organ and cardiac ischemic time, and reduces the opportunity for air and particulate embolization during aortic repair. Conclusions Branch-first total aortic arch repair allows continuous antegrade cerebral perfusion and shortens distal organ and cardiac ischemic time, with unobstructed access to the full extent of the diseased aortic arch. |
| Databáze: | OpenAIRE |
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