Deep Hypothermia and Circulatory Arrest for Surgery of High Extracranial Internal Carotid Aneurysm

Botí, Eduardo Tebar; González, Iván Martín; Bahamonde, José A.; León, J. Martínez; Otero-Coto, Eduardo

doi:10.1016/j.athoracsur.2003.10.102

Cited by 6 publications

(1 citation statement)

References 5 publications

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“…There are reports regarding their management using deep hypothermic arrest. 3 In this report, we have highlighted the extension of the scope of CPB beyond routine cardiac surgery in a tertiary care centre in a developing country. The application of CPB with DHTCA is a novel strategy to facilitate such a procedure which, otherwise, would have been almost impossible to carry out without resulting in morbidities such as cranial nerve damage along with embolization of thrombus in the aneurysm.…”

Section: Discussionmentioning

confidence: 95%

Deep hypothermic total circulatory arrest for internal carotid artery aneurysm extending into the cranium: experience from a developing country

et al. 2010

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Cardiopulmonary bypass is commonplace for acquired and congenital cardiac procedures. It has also stretched to facilitate complicated non-cardiac operations. Carotid artery aneurysms are treated both with surgical repair without cardiopulmonary bypass (CPB) and, occasionally, by utilizing CPB perfusion techniques. We have successfully repaired an internal carotid artery aneurysm, extending into cranium in a 30-year-old woman, by establishing deep hypothermic circulatory arrest on cardiopulmonary bypass.

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Section: Discussionmentioning

confidence: 95%

Deep hypothermic total circulatory arrest for internal carotid artery aneurysm extending into the cranium: experience from a developing country

et al. 2010

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Mycotic aneurysm of internal carotid artery — A case report

Raghuram

John

Balaji

et al. 2008

Indian J Thorac Cardiovasc Surg

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A 7-year-old boy presented to our Ear Nose and Throat (E.N.T) Department with a painful bleeding swelling in the throat. He gave history of fever of 10 days duration and bilateral painful parotid swelling. The swelling on the right side subsided within a few days but the one on the left side progressively increased and produced a painful bulge inside the throat. It ruptured on the day of presentation to our hospital and bled considerably. On examination he was febrile, anxious and pale. There was a diffuse painful pulsatile swelling in the left parotid and submandibular regions. The examination of the throat revealed a bulge in left lateral pharyngeal wall with a huge clot sitting at the summit. A computed tomography (CT) Scan of the neck ( Fig. 1) was done which revealed a large parapharyngeal lesion with encasement of internal carotid artery. Small out pouching of carotid wall was seen. An emergency carotid angiogram was done to confirm the diagnosis (Fig. 2). Since he had evidence of infection and active bleeding, he was taken up for emergency carotid ligation. Under general anesthesia a curved incision was made in the neck and the proximal control was obtained. The incision was extended upwards and superficial lobe and deep lobe of parotid gland were excised piecemeal taking care to preserve the facial and hypoglossal nerves and expose the internal carotid artery high up in the neck disappearing into the temporal bone. The distal Abstract Mycotic aneurysms are rare entities. Most of them occur in aorta or femoral artery. Mycotic aneurysm of extracranial carotid artery has been reported quite infrequently in the literature. Surgical intervention is mandatory. The ideal treatment is to excise the aneurysm and restore the circulation by interposition grafting by saphenous vein. However the limited access to extracranial internal carotid artery and the presence of infection at that site may not always allow the ideal management. Ligation of the aneurysm is a practical lifesaving method in such cases. We are presenting our experience with one such patient who presented with a painful bleeding swelling in the throat and was successfully treated with ligation of internal carotid artery. (Ind J Thorac Cardiovasc Surg 2008; 24: 145-147)

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