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Modified Arch First Technique for Total Arch Replacement using Hypothermic Circulatory Arrest and Retrograde Cerebral Perfusion

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Advances in Understanding Aortic Diseases

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Summary

Patients and methods: From 1998 to 2007, there were 90 consecutive patients who underwent the modified arch first technique for total arch replacement using hypothermic circulatory arrest (HCA) and retrograde cerebral perfusion (RCP). There were 63 true aneurysms, and 13 chronic and 11 acute Stanford type A dissections. Sixteen cases were operated on as emergencies.

Results: The mean operation time was approximately 6.5 hr. The mean cardiopulmonary bypass time exceeded 3.5 hr as a result of applying HCA, with an average lowest esophageal temperature of 19.2°C. The mean HCA time with RCP was 31.2 ± 8.6 min. However, the lower body ischemic time was 80 min because of double segment distal anastomoses were performed. The cardiac ischemic time was nearly 2 hr. There were 4 hospital deaths. Nine patients (10%) suffered from stroke. Reversible ischemic neurological deficit was complicated during the operation in six cases (7%).

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Authors and Affiliations

  1. Division of Cardiac Surgery, Department of Surgery Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Yuichi Ueda (Professor and Chairman)

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  1. Yuichi Ueda
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Editors and Affiliations

  1. Cardio-vascular Center Hokkaido Ohno Hospital, 4-1Nishino, Nishi-ku, Sapporo, 063-0034, Japan

    Teruhisa Kazui M.D.

  2. Department of Cardiothoracic Surgery Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Shinichi Takamoto M.D.

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© 2009 Springer

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Ueda, Y. (2009). Modified Arch First Technique for Total Arch Replacement using Hypothermic Circulatory Arrest and Retrograde Cerebral Perfusion. In: Kazui, T., Takamoto, S. (eds) Advances in Understanding Aortic Diseases. Springer, Tokyo. https://doi.org/10.1007/978-4-431-99237-0_20

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  • DOI: https://doi.org/10.1007/978-4-431-99237-0_20

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-99236-3

  • Online ISBN: 978-4-431-99237-0

  • eBook Packages: MedicineMedicine (R0)

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