Transapical aortic cannulation using a deep hypothermic procedure through a left thoracotomy for acute traumatic aortic rupture

  • Takahiro Takemura
  • Yoshiei Shimamura
  • Masayuki Sakaguchi
  • Yasutoshi Tsuda
  • Shizuko Iwasa
Article

Abstract

We describe a transapical aortic cannulation procedure through a left thoracotomy for a case of acute traumatic aortic rupture. A 26-year-old man was involved in a motor vehicle accident and admitted in a state of hypovolemic shock. Chest computed tomography findings revealed a rupture of the proximal portion of the descending aorta and a massive hematoma around the aorta extending into the thoracic cavity. Under hypothermic circulatory arrest, he underwent an emergency graft replacement through a left thoracotomy. We used transapical aortic cannulation together with femoral cannulation, in order to avoid malperfusion of the brain and upper body that can occur as a result of retrograde perfusion. The postoperative outcome was favorable. Transapical cannulation is a useful alternative for hypothermic aortic operations through a left thoracotomy.

Key words

transapical aortic cannulation left thoracotomy traumatic aortic rupture 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Zwart HH, Kralios A, Kwan-Gett CS, Backman DK, Foote JL, Andrade JD, et al. First clinical application of transarterial closed-chest left ventricular (TaCLV) bypass. Trans Am Soc Artif Intern Organs 1970; 16: 386–91.PubMedGoogle Scholar
  2. 2.
    Yamamoto S, Hosoda Y, Yamasaki M, Ishikawa N, Fuchimoto K, Fukuda T. Transapical aortic cannulation for acute aortic dissection to prevent malperfusion and cerebral complications. Tex Heart Inst J 2001; 28: 42–3.PubMedGoogle Scholar
  3. 3.
    Fukuda I, Aikawa S, Imazuru T, Osaka M. Transapical aortic cannulation for acute aortic dissection with diffuse atherosclerosis. J Thorac Cardiovasc Surg 2002; 123: 369–70.PubMedCrossRefGoogle Scholar
  4. 4.
    Shiiya N, Yasuda K, Murashita T, Suto Y, Kanaoka T, Matsui Y, et al. Transapical aortic cannulation for hypothermic aortic operation through a left thoracotomy: An alternative to avoid retrograde arterial perfusion. J Thorac Cardiovasc Surg 1997; 113: 1113–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Katoh T, Gohra H, Hamano K, Takenaka H, Zempo N, Esato K. Right axillary cannulation in the left thoracotomy for thoracic aortic aneurysm. Ann Thorac Surg 2000; 70: 311–3.PubMedCrossRefGoogle Scholar
  6. 6.
    Westaby S, Katsumata T. Proximal aortic perfusion for complex arch and descending aortic disease. J Thorac Cardiovasc Surg 1998; 115: 162–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Galli R, Pacini D, Bartolomeo RD, Fattori R, Turinetto B, Grillone G, et al. Surgical indications and timing of repair of traumatic ruptures of thoracic aorta. Ann Thorac Surg 1998; 65: 454–60.CrossRefGoogle Scholar
  8. 8.
    Kwon CC, Gill IS, Fallon WF, Yowler C, Akhrass R, Temes T, et al. Delayed operative intervention in the management of traumatic descending thoracic aortic rupture. Ann Thorac Surg 2002; 74: S1888–91.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Association for Thoracic Surgery 2003

Authors and Affiliations

  • Takahiro Takemura
    • 1
  • Yoshiei Shimamura
    • 1
  • Masayuki Sakaguchi
    • 1
  • Yasutoshi Tsuda
    • 1
  • Shizuko Iwasa
    • 1
  1. 1.Department of Cardiovascular SurgeryNational Nagano HospitalNaganoJapan

Personalised recommendations