Right axillary arterial perfusion for descending thoracic or thoracoabdominal aortic aneurysm repair with open proximal anastomosis through left thoracotomy

Kawaharada, Nobuyoshi; Ito, Toshiro; Naraoka, Shuichi; Hagiwara, Takayuki; Koyanagi, Toshiya; Kurimoto, Yoshihiko; Higami, Tetsuya

doi:10.1007/s11748-014-0404-z

Cited by 6 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kawaharada et al reported the incidence rate of cerebral embolism as 3.4% in DTA or TAA repair under deep hypothermic CA for a mean duration of 28 min, and advocated the use of right axillary arterial perfusion. 13) In comparison, our patient cohort had a higher incidence of PND (6.7%). However, it is noteworthy that the mean duration of SCP for our …”

Section: Discussionmentioning

confidence: 62%

Selective Cerebral Perfusion with the Open Proximal Technique during Descending Thoracic or Thoracoabdominal Aortic Repair: An Option of Choice to Reduce Neurologic Complications

Hosoyama

Kawamoto

Kumagai

et al. 2018

ATCS

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 62%

Selective Cerebral Perfusion with the Open Proximal Technique during Descending Thoracic or Thoracoabdominal Aortic Repair: An Option of Choice to Reduce Neurologic Complications

Hosoyama

Kawamoto

Kumagai

et al. 2018

ATCS

View full text Add to dashboard Cite

“…However, it is a very invasive surgical procedure, with reported hospital mortality and stroke rates of 3%–10% and 3%–11%, respectively. 1,2,4,9,11,12 Furthermore, if the distal arch or proximal descending aorta has aneurysmal or atherosclerotic changes or dissection, aortic crossclamping may cause vascular injury or stroke. Although open proximal anastomosis with HCA can be performed to prevent such complications, it is an invasive procedure.…”

Section: Discussionmentioning

confidence: 99%

“…After exposing the aortic aneurysm, extracorporeal circulation was established. Previously, arterial flow was returned through the right axillary and femoral arteries, 9 but we have recently started using the left axillary and femoral arteries. Venous inflow to the extracorporeal circuit was obtained from the femoral vein.…”

Section: Methodsmentioning

confidence: 99%

Two-stage repair of DeBakey type IIIb aneurysm, using total arch replacement

Yanase

Ito

Arihara

et al. 2019

Asian Cardiovasc Thorac Ann

Self Cite

View full text Add to dashboard Cite

Background Open repair for chronic DeBakey type IIIb dissecting aortic aneurysm is an invasive procedure involving open proximal anastomosis under hypothermic cardiac arrest, with significant morbidity in high-risk patients. We adopted a two-stage repair strategy using total arch replacement with the elephant trunk technique, which enables aortic crossclamping and avoids open proximal anastomosis at the second-stage graft replacement through a left thoracotomy. Methods From January 2008 to October 2018, we performed DeBakey type IIIb dissecting aortic aneurysm repair in 76 cases, and compared the results of two-stage repair (group 1, 25 cases) and single-stage repair using graft replacement with open proximal anastomosis through a left thoracotomy (group 2, 31 cases). Results In group 1, the elephant trunk technique was successful in all cases. The second intervention included endovascular repair (13 cases) and graft replacement through a left thoracotomy (7 cases). Five cases were followed up conservatively because the false lumen was thrombosed after the elephant trunk technique. Aorta-related adverse events were seen in 5 cases in group 1 (1 re-dissection, 1 rupture, 2 stent-graft-induced new entries, 1 stent-graft migration) and 6 in group 2 (1 additional thoracic endovascular aortic repair, 1 rupture, 4 acute type A aortic dissections). There were no statistical differences between the two groups regarding aorta-related adverse events and death. The postoperative course was acceptable in both groups. Conclusions Single-stage repair with open proximal anastomosis is an option in patients not at high risk for invasive surgery, while two-stage repair is recommended for high-risk patients.

show abstract

“…Shiiya et al reported using antegrade perfusion by transapical aortic cannulation to prevent debris scattering due to retrograde perfusion from the femoral artery in a patient undergoing thoracoabdominal aortic repair by left thoracotomy [ 7 ], and Takemura et al reported the usefulness of transapical cannulation in preventing malperfusion during a deep hypothermic procedure to repair an acute traumatic descending aortic rupture [ 10 ]. Although antegrade perfusion via the axillary artery is safe and possible [ 11 ], it is difficult to ensure the visual field during a left thoracotomy procedure.…”

Section: Discussionmentioning

confidence: 99%

Transapical aortic perfusion using a deep hypothermic procedure to prevent dissecting lung injury during re-do thoracoabdominal aortic aneurysm surgery

Kise

Kuniyoshi

Ando

et al. 2017

J Cardiothorac Surg

View full text Add to dashboard Cite

BackgroundAvoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery.Case presentationA 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis. The deep hypothermia was induced with bilateral infusion of cardiopulmonary bypass by femoral artery cannulation for the lower body and by transapical cannulation for the upper body because of easy access. There was no hemorrhagic tendency after deep hypothermic bypass. The patient was discharged uneventfully.ConclusionsFor upper body perfusion, transapical aortic cannulation was a simple and effective procedure during left thoracotomy.

show abstract

Right axillary arterial perfusion for descending thoracic or thoracoabdominal aortic aneurysm repair with open proximal anastomosis through left thoracotomy

Abstract: Right axillary perfusion facilitates easy evacuation of air and allows prompt recommencement of upper body circulation. Consequently, it minimizes the risk of cerebral embolism or complications in relation to aortic cannulation through left thoracotomy.

Cited by 6 publications

References 14 publications

Selective Cerebral Perfusion with the Open Proximal Technique during Descending Thoracic or Thoracoabdominal Aortic Repair: An Option of Choice to Reduce Neurologic Complications

Selective Cerebral Perfusion with the Open Proximal Technique during Descending Thoracic or Thoracoabdominal Aortic Repair: An Option of Choice to Reduce Neurologic Complications

Two-stage repair of DeBakey type IIIb aneurysm, using total arch replacement

Transapical aortic perfusion using a deep hypothermic procedure to prevent dissecting lung injury during re-do thoracoabdominal aortic aneurysm surgery

Contact Info

Product

Resources

About