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J Thorac Cardiovasc Surg 2007;133:278
© 2007 The American Association for Thoracic Surgery

Letter to the Editor

Reply to the Editor

Alejandro Aris, MD, PhD, Maria Luz Maestre, MD, Maria Teresa Subirana, MD

Hospital de la Santa Creui Sant Pau, Departments of Cardiac Surgery, Anesthesiology and Cardiology, Barcelona, Spain

We thank Dr Krishnan and colleagues for their letter, which proves that resourceful surgeons can be found worldwide. They report the use of a heart-lifting device to perform an ascending–descending aortic bypass in a 15-year-old girl with previous aortic arch surgery. Because of previous thoracotomy, as in our reported case,1Go they elected this type of bypass, which has been increasingly used for reoperations in the aortic arch and isthmus in view of its excellent long-term results.2Go The figure in the letter is almost identical to the one appearing in our article, except for the fact that they routed the graft around the right margin of the heart. Direction of the graft should conform to the individual anatomy encountered in each case. Again, the excellent exposure achieved with the use of a lifting device to retract the heart is shown and demonstrates that there is no need to have an assistant’s hand cramming the operative field. This report enhances the feasibility of the procedure and might help to popularize it. We encourage surgeons to try it and foresee that it will be performed without the use of cardiopulmonary bypass in selected cases.

References

  1. Aris A, Cobiella J, Maestre ML, Subirana MT. Ascending-descending aortic bypass with the aid of a heart-lifting device. J Thorac Cardiovasc Surg 2006;132:433-434.[Free Full Text]
  2. Oliveira SA, Lisboa LAF, Dallan LAO, Abreu F, Rochitte CE, Souza JM. Extraanatomic aortic bypass for repair of aortic arch coarctation via sternotomy. Midterm clinical and magnetic resonance imaging results. CAC Ann Thorac Surg 2003;76:1962-1966.[Abstract/Free Full Text]

Related Article

Ascending–descending aortic bypass with the aid of a heart-lifting device
Ganapathy Subramaniam Krishnan, Ravi Agarwal, and Kotturathu M. Cherian
J. Thorac. Cardiovasc. Surg. 2007 133: 277-278. [Extract] [Full Text] [PDF]




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