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The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 1051-1063, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
RB Griepp, EB Stinson, JF Hollingsworth and D Buehler
Four patients are reported in whom the aortic arch and variable portions of
the ascending and descending aorta were replaced with a prosthesis. In
three patients the preoperative diagnosis was dissecting aneurysm of the
aortic arch and in one an arteriosclerotic aneurysm of the aortic arch was
present. A combination of surface cooling and cardiopulmonary bypass was
utilized to produce total body hypothermia. Arch replacement was carried
out during a period of total circulatory arrest. Cardiopulmonary bypass was
then utilized to warm the patient and resuscitate the heart. The average
duration of cerebral ischemia was 43 minutes and the average duration of
myocardial ischemia was 74 minutes. The average lowest esophageal
temperature was 14 degrees C., and the average lowest rectal temperature
was 18 degrees C. Three patients are alive and well 4 to 13 months
following surgery. One patient died 4 days postoperatively of pulmonary
insufficiency. This experience indicates that by utilizing total body
hypothermia and circulatory arrest aortic arch replacement can be carried
out with an acceptable mortality rate. Corrective surgery could be offered
to patients with life-threatening enlarging aneurysms of the aortic arch.
ARTICLES
Prosthetic replacement of the aortic arch
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S. L. Lansman, J. N. McCullough, K. H. Nguyen, D. Spielvogel, J. J. Klein, J. D. Galla, M. A. Ergin, and R. B. Griepp Subtypes of acute aortic dissection Ann. Thorac. Surg., June 1, 1999; 67(6): 1975 - 1978. [Abstract] [Full Text] [PDF]
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H. Ogino, Y. Ueda, T. Sugita, Y. Sakakibara, K. Matsuyama, K. Matsubayashi, and T. Nomoto Retrograde Cerebral Perfusion for Aortic Arch Surgery in Octogenarians Asian Cardiovasc Thorac Ann, March 1, 1999; 7(1): 27 - 29. [Abstract] [Full Text] [PDF]
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Y. Okita, M. Ando, K. Minatoya, S. Kitamura, S. Takamoto, and N. Nakajima Predictive factors for mortality and cerebral complications in arteriosclerotic aneurysm of the aortic arch Ann. Thorac. Surg., January 1, 1999; 67(1): 72 - 78. [Abstract] [Full Text] [PDF]
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C. K. Rokkas and N. T. Kouchoukos SINGLE-STAGE EXTENSIVE REPLACEMENT OF THE THORACIC AORTA: THE ARCH-FIRST TECHNIQUE J. Thorac. Cardiovasc. Surg., January 1, 1999; 117(1): 99 - 105. [Abstract] [Full Text] [PDF]
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T. Calkavur, Y. Atay, T. Yagdi, M. Cikirikcoglu, L. Can, U. Gurcun, M. Ozbaran, O. Bilkay, and S. Buket Clinical Results of Retrograde Cerebral Perfusion in Treatment of Aortic Disease Asian Cardiovasc Thorac Ann, December 1, 1998; 6(4): 288 - 294. [Abstract] [Full Text] [PDF]
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Y. Moshkovitz, T. E. David, M. Caleb, C. M. Feindel, and M. P.L. de Sa Circulatory arrest under moderate systemic hypothermia and cold retrograde cerebral perfusion Ann. Thorac. Surg., October 1, 1998; 66(4): 1179 - 1184. [Abstract] [Full Text] [PDF]
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T. Sasajima, K. Goh, H. Asada, T. Sugawara, and N. Ohtani Tube device for facilitating distal anastomosis in aortic arch replacement Ann. Thorac. Surg., October 1, 1998; 66(4): 1436 - 1437. [Abstract] [Full Text] [PDF]
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C. L. Stowe, M. A. Baertlein, M. D. Wierman, M. Rucker, and G. Ebra Surgical management of ascending and aortic arch disease: refined techniques with improved results Ann. Thorac. Surg., August 1, 1998; 66(2): 388 - 395. [Abstract] [Full Text] [PDF]
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A. E Manapat, J. M Garcia, J. B Barril, G. A Lopez, and D. A Talavera Repair of Thoracic Aortic Aneurysm and Dissection Using Deep-Hypothermic Circulatory Arrest Asian Cardiovasc Thorac Ann, June 1, 1998; 6(2): 95 - 100. [Abstract] [Full Text] [PDF]
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Y. Okita, S. Takamoto, M. Ando, T. Morota, R. Matsukawa, and Y. Kawashima Mortality And Cerebral Outcome In Patients Who Underwent Aortic Arch Operations Using Deep Hypothermic Circulatory Arrest With Retrograde Cerebral Perfusion: No Relation Of Early Death, Stroke, And Delirium To The Duration Of Circulatory Arrest J. Thorac. Cardiovasc. Surg., January 1, 1998; 115(1): 129 - 133. [Abstract] [Full Text] [PDF]
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M. Grabenwoger, M. Ehrlich, F. Cartes-Zumelzu, M. Mittlbock, G. Weigel, G. Laufer, E. Wolner, and M. Havel Surgical Treatment of Aortic Arch Aneurysms in Profound Hypothermia and Circulatory Arrest Ann. Thorac. Surg., October 1, 1997; 64(4): 1067 - 1071. [Abstract] [Full Text]
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C. Yamashita, M. Okada, K. Ataka, M. Yoshida, N. Yoshimura, T. Azami, K. Nakagiri, H. Wakiyama, and T. Yamashita Open Distal Anastomosis in Retrograde Cerebral Perfusion for Repair of Ascending Aortic Dissection Ann. Thorac. Surg., September 1, 1997; 64(3): 665 - 669. [Abstract] [Full Text]
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T. Katoh, K. Esato, H. Gohra, K. Hamano, Y. Fujimura, N. Zempo, K. Nakashima, and T. Maekawa Evaluation of Brain Oxygenation During Selective Cerebral Perfusion by Near-Infrared Spectroscopy Ann. Thorac. Surg., August 1, 1997; 64(2): 432 - 436. [Abstract] [Full Text]
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H. J. Safi, G. V. Letsou, D. C. Iliopoulos, M. H. Subramaniam, C. C. Miller III, H. Hassoun, P. J. Asimacopoulos, and J. C. Baldwin Impact of Retrograde Cerebral Perfusion on Ascending Aortic and Arch Aneurysm Repair Ann. Thorac. Surg., June 1, 1997; 63(6): 1601 - 1607. [Abstract] [Full Text]
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 J.O. Fulton, H.D. Louwrens, J. Marr, and J. Hewitson Profound Hypothermia and Total Circulatory Arrest in the Management of a Massive False Aneurysm of the Subclavian Artery: A Case Report Vascular and Endovascular Surgery, March 1, 1997; 31(2): 199 - 203. [Abstract] [PDF]
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J. O. Fulton and J. G. Brink Complex Thoracic Vascular Injury Repair Using Deep Hypothermia and Circulatory Arrest Ann. Thorac. Surg., February 1, 1997; 63(2): 557 - 559. [Abstract] [Full Text]
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L. G. Svensson Central Nervous System Injury After Aortic Operations: Profits of Amending Old Ways Ann. Thorac. Surg., January 1, 1997; 63(1): 9 - 11. [Full Text]
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T. Sakamoto, T. Yoshida, T. Sugano, A. Kudoh, and A. Suzuki Simplified Technique for Hemi-Arch Replacement During Open Distal Anastomosis: The ``Calla'' Method Ann. Thorac. Surg., March 1, 1996; 61(3): 1021 - 1023. [Abstract] [Full Text]
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J. E. Bavaria, Y. J. Woo, R. A. Hall, J. P. Carpenter, and T. J. Gardner Retrograde Cerebral and Distal Aortic Perfusion During Ascending and Thoracoabdominal Aortic Operations Ann. Thorac. Surg., August 1, 1995; 60(2): 345 - 352. [Abstract] [Full Text]
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M. K. Heinemann, B. Buehner, M. J. Jurmann, and H.-G. Borst Use of the ``Elephant Trunk Technique'' in Aortic Surgery Ann. Thorac. Surg., July 1, 1995; 60(1): 2 - 6. [Abstract] [Full Text]
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S. Buket, A. Alayunt, B. Discigil, A. Apaydin, M. Yuksel, and I. Durmaz Ege Continuous retrograde cerebral perfusion supplies substrates for brain metabolism during hypothermic circulatory arrest Perfusion, July 1, 1995; 10(4): 237 - 244. [Abstract] [PDF]
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L. G. Svensson, J. Sun, E. Nadolny, and W. A. Kimmel Prospective Evaluation of Minimal Blood Use for Ascending Aorta and Aortic Arch Operations Ann. Thorac. Surg., June 1, 1995; 59(6): 1501 - 1508. [Abstract] [Full Text]
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B. W. Lytle, P. M. McCarthy, K. M. Meaney, R. W. Stewart, and D. M. Cosgrove III Systemic hypothermia and circulatory arrest combined with arterial perfusion of the superior vena cavaEffective intraoperative cerebral protection J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 738 - 743. [Abstract] [Full Text]
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H. Tanaka, T. Kazui, H. Sato, N. Inoue, O. Yamada, and S. Komatsu Experimental Study on the Optimum Flow Rate and Pressure for Selective Cerebral Perfusion Ann. Thorac. Surg., March 1, 1995; 59(3): 651 - 657. [Abstract] [Full Text]
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G. M. Deeb, E. Jenkins, S. F. Bolling, L. A. Brunsting, D. M. Williams, L. E. Quint, and N. D. Deeb Retrograde cerebral perfusion during hypothermic circulatory arrest reduces neurologic morbidity J. Thorac. Cardiovasc. Surg., February 1, 1995; 109(2): 259 - 268. [Abstract] [Full Text]
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J. S. Coselli, S. Buket, and B. Djukanovic Aortic Arch Operation: Current Treatment and Results Ann. Thorac. Surg., January 1, 1995; 59(1): 19 - 27. [Abstract] [Full Text]
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S. A Raskin and J. S Coselli Retrograde cerebral perfusion: overview, techniques and results Perfusion, January 1, 1995; 10(1): 51 - 57. [Abstract] [PDF]
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K. Yasuura, H. Okamoto, Y. Ogawa, A. Matsuura, T. Asakura, A. Seki, M. Hoshino, T. Maseki, M. Sawazaki, T. Itoh, et al. Resection of aortic aneurysms without aortic clamp technique with the aid of hypothermic total body retrograde perfusion J. Thorac. Cardiovasc. Surg., May 1, 1994; 107(5): 1237 - 1243. [Abstract] [Full Text]
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