Mortality and morbidity after total arch replacement using a branched arch graft with selective antegrade cerebral perfusion

Ueda, Toshihiko; Shimizu, Hideyuki; Hashizume, Kenichi; Koizumi, Kiyoshi; Mori, Mitsuharu; Shin, Hankei; Yozu, Ryohei

doi:10.1016/s0003-4975(03)01136-6

Cited by 36 publications

(29 citation statements)

References 17 publications

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“…Using an antegrade perfusion strategy with moderate cooling, Kazui et al [10] have demonstrated perioperative stroke rates as low as 3.2% and mortality of 9.3%. Similar results have been achieved by other highly experienced groups, including Safi et al [20], Ueda et al [21] and LeMaire et al [22] using a variety of neuroprotective strategies in candidates with good operative risk. To date, more investigational techniques such as hybrid approaches have been reserved for the most high-risk patients, who are not deemed to be suitable open candidates.…”

Section: Arch Aneurysm/chronic Dissectionsupporting

confidence: 83%

Complex aortic arch aneurysm and dissections: hybrid techniques for surgical and endovascular therapy

Desai

Szeto

2009

Current Opinion in Cardiology

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Section: Arch Aneurysm/chronic Dissectionsupporting

confidence: 83%

Complex aortic arch aneurysm and dissections: hybrid techniques for surgical and endovascular therapy

Desai

Szeto

2009

Current Opinion in Cardiology

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“…Data are reported as mean ± SD, median (interquartile range), or number (%). Operative mortality 2% 1 4.6% 10 4.7% 11 4.9% 12 6.8% 15 2% 16 6.8% 14 6.8% 13 Neurologic dysfunction 5% 1 9.4% 11 9.8% 12 14% 17 5% 16 9.1% 14 Respiratory support 2days 20%-51% 13 5days 5%-30% 13 Acute renal failure 11% 1 3.7% 10 6% 11 13.1% 12…”

Section: Resultsmentioning

confidence: 99%

Short-term Outcomes of Modified Y-Graft Technique in Acute Type A Aortic Dissection Using the Femoral Artery Bypass and One Minute Systemic Circulatory Arrest Technique

Sun

Zhao

Huo

et al. 2020

Preprint

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Objective: Aortic arch replacement in acute type A aortic dissection patients remains a most challenging cardiovascular operation. This article aims to show our Modified Y-Graft Technique using the Femoral Artery Bypass (FAB) and the One Minute Systemic Circulatory Arrest (OSCA) Technique and assess the short-term outcomes of the patients.Methods: Between February 2015 and November 2017, 51 patients with acute type A aortic dissection underwent aortic arch replacement. Among them, 23 patients’ procedure used FAB and 28 patients utilized both FAB and OSCA. The intraoperative data and postoperative follow-up data were recorded. The follow-up data of patients with traditional Y-graft technique were collected from previous reported studies.Results: In FAB group, two patients died for pulmonary infection (30-day survival rate 91.3%), and two patients paralyzed from the waist down. The hemodialysis was performed for five patients (21.7%) before hospital discharge. Fifteen patients (65.2%) received more than 2-day’s respiratory support and 8 patients (34.8%) received more than 5-day’s respiratory support. These follow-up data are basically flat or precede to the patients with traditional Y-graft technique. Furthermore, compared to the FAB Group, the morbidity of the neurologic dysfunction and the acute renal failure was significantly reduced in FAB+OSCA Group. Besides, the respiratory support, the length of the postoperative stay and the ICU stay were shortened.Conclusions: This study clarified the feasibility of FAB and OSCA technique in modifying Y-graft technique. The acute type A aortic dissection patients tend to have less surgical complications and favorable short-term outcomes by this surgery.

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“…However, performing distal anastomosis of the branched graft to the descending thoracic aorta is not always easy. 8 Because atheromatous changes often involve only the proximal descending thoracic aorta in patients with an aortic arch aneurysm, the distal anastomotic site is sometimes selected at the mid-descending thoracic aorta in the deep left thoracic cavity. If anastomosis of the graft to the descending thoracic aorta needs to be performed more than several centimeters distal to the subclavian artery, exposure of the distal anastomotic site through a median sternotomy may be labori- This device can sheathe the graft component and hide the four side branches and the distal graft body.…”

Section: Discussionmentioning

confidence: 99%

A Newly Designed Holder for Grafts with Four Side Branches Used in Total Arch Replacement

et al. 2005

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Grafts with four presewn side branches have proven very useful for total aortic arch replacement worldwide. However, the four side branches often obscure the surgeon's view of the distal anastomotic site. Thus, we designed a holder for this graft, which sheaths and hides the graft body and branches, allowing the surgeon a better view of the distal anastomosis. By using this device, distal anastomosis can be achieved early and quickly without obstruction of the surgeon's view, resulting in reduced cardiac ischemic time in aortic arch surgery.

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Mortality and morbidity after total arch replacement using a branched arch graft with selective antegrade cerebral perfusion

Cited by 36 publications

References 17 publications

Complex aortic arch aneurysm and dissections: hybrid techniques for surgical and endovascular therapy

Complex aortic arch aneurysm and dissections: hybrid techniques for surgical and endovascular therapy

Short-term Outcomes of Modified Y-Graft Technique in Acute Type A Aortic Dissection Using the Femoral Artery Bypass and One Minute Systemic Circulatory Arrest Technique

A Newly Designed Holder for Grafts with Four Side Branches Used in Total Arch Replacement

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