HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Crawford, E. S. Articles by Schuessler, J. S. Search for Related Content PubMed PubMed Citation Articles by Crawford, E. S. Articles by Schuessler, J. S.

The Journal of Thoracic and Cardiovascular Surgery, Vol 78, 383-393, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Treatment of aneurysm of transverse aortic arch

ES Crawford, SA Saleh and JS Schuessler

Although aneurysms involving the aortic arch are usually well localized and amenable to reconstructive operation, the reported results of this form of therapy at this level are not as good as in other portions of the aorta. The difference is due to cerebral and bleeding disturbances associated with cerebral protection techniques. This report describes 30 patients and emphasizes the variability of extent of these lesions and the results of methods employed for cerebral protection, which varied according to extent of disease. The aneurysm involved all but the proximal ascending aorta in one patient and was replaced with a permanent ascending aorta-innominate and left common carotid artery bypass graft. Eight aneurysms were limited to the transverse arch; one was removed with the aid of temporary bypass and seven with cardiopulmonary bypass and separate brachiocephalic normothermic perfusion. Temporary and permanent bypass grafts were used in four patients with lesser involvement. None of these techniques was used in 17 patients who had distal arch involvement. Of the 30 patients, 26 survived and 18 are still alive despite the treatment being spread over a 22 year period. Cerebral complications occurred in 3 patients, two of whom died. These problems were avoided in five patients treated more recently by using lows flows under low pressures. Coagulopathies did not occur. Although the technique of cardiopulmonary bypass, profound hypothermia, and circulatory arrest provides a more convenient and technically simpler method of operation, the disadvantages of coagulopathies with excessive bleeding, pulmonary problems, and lack of consistent cerebral protection argue against its routine use at this time.

This article has been cited by other articles:

				T. Kazui Total arch replacement: technique of separate reimplantation of epi-aortic vessels MMCTS, January 2, 2007; 2007(0102): 1925. [Abstract] [Full Text] [PDF]

				E. A. Tovar Stapling of an aortic arch aneurysm Ann. Thorac. Surg., March 1, 2001; 71(3): 1011 - 1013. [Abstract] [Full Text] [PDF]

				K. Inoue, H. Hosokawa, T. Iwase, M. Sato, Y. Yoshida, K. Ueno, A. Tsubokawa, T. Tanaka, S. Tamaki, and T. Suzuki Aortic Arch Reconstruction by Transluminally Placed Endovascular Branched Stent Graft Circulation, November 9, 1999; 100(90002): II-316 - 321. [Abstract] [Full Text] [PDF]

				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]

				J. L MacDonald, A. G Cleland, R. L Mayer, and M. J Henderson Extracorporeal circuit design considerations for giant intracranial aneurysm repair Perfusion, May 1, 1997; 12(3): 193 - 196. [Abstract] [PDF]

				H.H. Scheld, G. Gorlach, J. Boldt, F. Dapper, and R. Moosdorf Decreasing the Risk of Aortic Arch Replacement Vascular and Endovascular Surgery, April 1, 1990; 24(3): 191 - 197. [Abstract] [PDF]