Background The surgical approach to pathologies of the Ascending Thoracic Aorta (ATA) that compromise aortic root and the aortic arch is currently one of the most complex interventions in the spectrum of cardiac surgery, where circulatory arrest with cerebral perfusion plays an important role for Success postoperative and patient survival. Case presentation We present the case of a 57-year-old patient with the only history of arterial hypertension and an ATA Aneurysm that compromised segment of the aortic root up to segment 2 of the aortic arch. A successful Bentall surgery was performed, debranching supra-aortic vessels with Total Circulatory Arrest with Deep Hypothermic Cerebral Perfusion-Antegrade Bilateral. Conclusions With the advent of new anesthetic and neuroprotection techniques, perioperative imaging protocols, advanced hemodynamic monitoring, and invaluable advances in perfusion and Extracorporeal Circulation with circulatory arrest, they have made this surgical challenge a valuable tool for today’s cardiovascular surgeon.

Introduction There is currently no universal and uniform pattern of peripheral arterial disease (PAD) in the lower limbs; however, it is influenced by various cardiovascular factors of the individual. The objective of this study was to identify the arteriographic patterns of PAD in the lower limbs according to cardiovascular factors in a Peruvian cohort of patients. Methods This is an analytical, observational, and retrospective study. The arteriographic patterns of PAD in the aortoiliac segment were analyzed with the TransAtlantic InterSociety Consensus (TASC-II) score and the Global Anatomic Staging System (GLASS) for the femoropopliteal (FP), infraopopliteal (IP), and pedial (P) segments in a Peruvian cohort from January 2018 to May 2021. Results 595 patients (833 extremities) were analyzed with a mean age of 67.54 ± 16.39 years, and the main cardiovascular factor was diabetes (65.04%). The patients older than 65 years with GLASS FP 4 (p = 0.042), IP 0 (p = 0.004), and P2 ( p = 0.047) presented significant findings: in men and women with GLASS IP 4 ( p = 0.031) and P 2 ( p = 0.045); diabetes with TASC-II A ( p = 0.031), GLASS FP 4 ( p = 0.038), IP 4 ( p = 0.009), and P2 ( p = 0.003); dyslipidemia with TASC-II D ( p = 0.027), GLASS FP 4 ( p = 0.038), IP 0 ( p = 0.009), and P0 ( p = 0.003); smoking with TASC-II D ( p = 0.001), GLASS FP 4 ( p = 0.049) and IP 0 ( p = 0.008); chronic coronary disease with GLASS IP 4 ( p = 0.049) and P2 ( p = 0.037); chronic kidney disease with GLASS FP 4 ( p=0.047), IP 4 ( p = 0.004), and P2 ( p = 0.016); and previous amputation history with GLASS IP 4 ( p = 0.015) and P2 ( p = 0.039). The most frequent arteriographic pattern of PAD in the lower limbs of our cohort was TASC-II A, GLASS FP 0 and 4, IP 0, and P2 ( p = 0.047). Conclusion Our work will allow the limb salvage teams to understand the behavior of PAD affectation in the population of our environment, allowing a timely control of cardiovascular risk factors, adequate revascularization planning, and a significant reduction in the risk of loss of limb.

La trombosis venosa superfi cial (TVS) de miembros inferiores venía considerándose como una patología de naturaleza benigna con un curso clínico autolimitado. Actualmente se conoce que sus potenciales complicaciones pueden ser graves o incluso mortales, como la trombosis venosa profunda o el tromboembolismo pulmonar. Existen diferentes formas de presentación clínica, factores de riesgo y diferentes tratamientos para su abordaje, principalmente en Atención Primaria.