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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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J. Rimpilainen, M. Pokela, K. Kiviluoma, V. Vainionpaa, J. Hirvonen, P. Ohtonen, V. Jantti, V. Anttila, H. Heinonen, and T. Juvonen The N-methyl-D-aspartate antagonist memantine has no neuroprotective effect during hypothermic circulatory arrest: A study in the chronic porcine model J. Thorac. Cardiovasc. Surg., May 1, 2001; 121(5): 957 - 968. [Abstract] [Full Text] [PDF]
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R. B. Griepp Cerebral protection during aortic arch surgery J. Thorac. Cardiovasc. Surg., March 1, 2001; 121(3): 425 - 427. [Full Text] [PDF]
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T. Hirotani, T. Kameda, T. Kumamoto, and S. Shirota Aortic arch repair using hypothermic circulatory arrest technique associated with pharmacological brain protection Eur. J. Cardiothorac. Surg., November 1, 2000; 18(5): 545 - 549. [Abstract] [Full Text] [PDF]
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V. Anttila, J. Rimpilainen, M. Pokela, K. Kiviluoma, M. Makiranta, V. Jantti, V. Vainionpaa, J. Hirvonen, and T. Juvonen Lamotrigine improves cerebral outcome after hypothermic circulatory arrest: A study in a chronic porcine model J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 247 - 255. [Abstract] [Full Text] [PDF]
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K. W. Jones TWENTY-FIVE YEARS OF EXCELLENCE: THE LEGACY AND THE CHALLENGE J. Thorac. Cardiovasc. Surg., February 1, 2000; 119(2): 203 - 209. [Full Text] [PDF]
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M. P. Ehrlich, W. C. Fang, M. Grabenwoger, A. Kocher, J. Ankersmit, G. Laufer, G. Grubhofer, M. Havel, and E. Wolner IMPACT OF RETROGRADE CEREBRAL PERFUSION ON AORTIC ARCH ANEURYSM REPAIR J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1026 - 1032. [Abstract] [Full Text] [PDF]
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