Open aortic arch repair without circulatory arrest by frozen elephant trunk in Ishimaru zone 0.
J Cardiothorac Surg
; 19(1): 203, 2024 Apr 13.
Article
em En
| MEDLINE
| ID: mdl-38615049
ABSTRACT
BACKGROUND:
Open arch surgery is technically demanding for the surgeon and surgically and biologically invasive for the patient, requiring a variably long period of hypothermic circulatory arrest. CASE PRESENTATION Here we present a case of an elderly patient with chronic renal failure and multiple splanchnic artery disease successfully treated for a rupturing pseudoaneurysm of the aortic arch with a technique that we developed for particularly frail patients. The procedure includes triple supra-aortic vessel perfusion; distal thoracic aorta antegrade perfusion; balloon endo-clamping of the descending aorta; and anastomosis of an off-the-shelf hybrid arch prosthesis in Ishimaru zone 0. These maneuvers allowed to maintain an extracorporeal circulation in the phase of distal anastomosis, instead of a period of circulatory arrest, employing just mild hypothermia technical details are depicted and discussed also in comparison with other methods proposed in the literature.CONCLUSIONS:
Being able to take advantage of both open surgery advancements and endovascular methods is the key to cardiovascular surgery success today in front of complex pathologies of the aorta increasing safety and reducing invasiveness of therapeutic options may progressively extend surgical candidacy to the frailest patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Implante de Prótese Vascular
/
Parada Cardíaca
Limite:
Aged
/
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article