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Concomitant aortic valve and ascending aorta replacement with moderate hypothermic circulatory arrest to treat an aortic bicuspid valve with post-stenotic dilatation

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Abstract

We recommend concomitant surgery for aortic valve replacement (AVR) and ascending aortic replacement using moderate hypothermic circulatory arrest (CA) for post-stenotic dilatation complicated by an aortic bicuspid valve. Cardiopulmonary bypass (CPB) was established from the right atrium to the dilated ascending aorta. As soon as the rectal temperature decreased to 28 °C, CA was commenced and the open distal anastomosis of a polyester prosthesis, without any cerebral perfusion, was completed. AVR was then carried out during rapid re-warming with CPB using a side arm of the prosthesis. This procedure exhibited safe and satisfactory results. There are many benefits of carrying out the procedure in this way; it avoids the requirement for cannulation to a calcified aortic arch, provides a good operative field, for an easier distal anastomosis and suturing at the valve site, and reduces the risk of further dilatation or dissection of the residual ascending aorta in the later phase.

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Conflict of interest

Mitsumasa Hata and co-authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Nihon University Hikarigaoka Hospital, 2-11-1 Hikarigaoka, Nerima-ku, Tokyo, 179-0072, Japan

    Mitsumasa Hata, Kenji Akiyama, Shinji Wakui & Ayako Takasaka

  2. Department of Cardiovascular, Respiratory, and General Surgery, Nihon University School of Medicine, 2-11-1 Hikarigaoka, Nerima-ku, Tokyo, 179-0072, Japan

    Motomi Shiono

Authors
  1. Mitsumasa Hata
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  2. Kenji Akiyama
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  3. Shinji Wakui
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  4. Ayako Takasaka
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  5. Motomi Shiono
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Correspondence to Mitsumasa Hata.

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Hata, M., Akiyama, K., Wakui, S. et al. Concomitant aortic valve and ascending aorta replacement with moderate hypothermic circulatory arrest to treat an aortic bicuspid valve with post-stenotic dilatation. Surg Today 42, 913–916 (2012). https://doi.org/10.1007/s00595-012-0217-6

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