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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


ARTICLES

Prosthetic replacement of the aortic arch

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.


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Eur. J. Cardiothorac. Surg.Home page
H. Ogino, Y. Ueda, T. Sugita, K. Morioka, Y. Sakakibara, K. Matsubayashi, and T. Nomoto
Monitoring of regional cerebral oxygenation by near-infrared spectroscopy during continuous retrograde cerebral perfusion for aortic arch surgery
Eur. J. Cardiothorac. Surg., October 1, 1999; 14(4): 415 - 418.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
C H Wong and R S Bonser
Retrograde cerebral perfusion: clinical and experimental aspects
Perfusion, July 1, 1999; 14(4): 247 - 256.
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Ann. Thorac. Surg.Home page
J. Bachet, D. Guilmet, B. Goudot, G. D. Dreyfus, P. Delentdecker, D. Brodaty, and C. Dubois
Antegrade cerebral perfusion with cold blood: a 13-year experience
Ann. Thorac. Surg., June 1, 1999; 67(6): 1874 - 1878.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
G. M. Deeb, D. M. Williams, L. E. Quint, H. M. Monaghan, and M. J. Shea
Risk analysis for aortic surgery using hypothermic circulatory arrest with retrograde cerebral perfusion
Ann. Thorac. Surg., June 1, 1999; 67(6): 1883 - 1886.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
J. N. McCullough, N. Zhang, D. L. Reich, T. S. Juvonen, J. J. Klein, D. Spielvogel, M. A. Ergin, and R. B. Griepp
Cerebral metabolic suppression during hypothermic circulatory arrest in humans
Ann. Thorac. Surg., June 1, 1999; 67(6): 1895 - 1899.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
K. M. Dossche, M. A.A.M. Schepens, W. J. Morshuis, F. E. Muysoms, J. J. Langemeijer, and F. E.E. Vermeulen
Antegrade selective cerebral perfusion in operations on the proximal thoracic aorta
Ann. Thorac. Surg., June 1, 1999; 67(6): 1904 - 1910.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
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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Asian Cardiovasc. Thorac. Ann.Home page
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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Ann. Thorac. Surg.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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Asian Cardiovasc. Thorac. Ann.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Asian Cardiovasc. Thorac. Ann.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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VASC ENDOVASCULAR SURGHome page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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PerfusionHome page
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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Ann. Thorac. Surg.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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PerfusionHome page
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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J. Thorac. Cardiovasc. Surg.Home page
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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