Abstract
The surgical management of aneurysms involving the aortic arch has been fraught with technical difficulties in the past. In only a few reports (1 – 3) has the surgical outcome in a sufficiently large number of patients with an aortic arch aneurysm been described. It is no exaggeration to say that the success of an operation for the repair of an aortic arch aneurysm mainly depends on how well the brain is protected from ischemia during aortic arch repair. For reconstruction of the aortic arch or adjacent part of the aorta, the following methods have been used as supportive techniques: hypothermic cardiopulmonary bypass (CPB) with selective cerebral perfusion (SCP) (4 – 6), hypothermic CPB with circulatory arrest (7 – 10) and hypothermic CPB with retrograde cerebral perfusion (11). From April 1989, based on results from our experimental studies (12), we have employed hypothermic CPB with SCP as the supportive method for the surgical treatment of aortic arch aneurysms. This report describes the SCP technique and results in 74 patients and includes discussion about its advantages.
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References
Livesay JJ, Cooly DA, Reul GJ, Walker WE, Frazier OH, Duncan JM, Ott DA (1983) Resection of aortic arch aneurysms: a comparison of hypothermic techniques in 60 patients. Ann Thorac Surg 36: 19–28
Crawford ES, Svensson LG, Coselli JS, Safi HJ, Hess KR (1989) Surgical treatment of aneurysm and/or dissection of the ascending aorta, transverse aortic arch. Factors influencing survival in 717 patients. J Thorac Cardiovasc Surg 98: 659–674
Bachet J, Guilmet D, Goudot B, Termignon JL, Teodori G, Dreyfus G, Brodaty D, Dubois C, Delentdecker P (1991) Cold cerebroplegia. A new technique of cerebral protection during operation on the transverse aortic arch. J Thorac Cardiovasc Surg 102: 85–94
Aoyagi S, Akashi H, Kubota Y, Momosaki M, Suzuki S, Ohryoji A, Kosuga K, Ohishi K (1993) Partial brachiocephalic perfusion in aortic arch replacement. Jpn J Surg 23: 331–337
Matsuda H, Nakano S, Shirakura R, Matsuwaka R, Ohkubo N, Ohtani M, Hirose H, Kawashima Y (1989) Surgery for aortic arch aneurysm with selective cerebral perfusion and hypothermic cardiopul-monary bypass. Circulation 80 (suppl I): 243–248
First WH, Baldwin JC, Starnes VA, Stinson EB, Oyer PE, Miller DC, Jamieson SW, Mitchell RS, Shumway NE (1986) A reconsideration of cerebral perfusion in aortic arch replacement. Ann Thorac Surg 42: 273–281
Griepp RB, Stinson EB, Hollingsworth JF, Buehler D (1975) Prosthetic replacement of the aortic arch. J Thorac Cardiovasc Surg 70: 1051–1063
Cooley DA, Ott DA, Frazier OH, Walker WE (1981) Surgical treatment of aneurysms of the transverse aortic arch: experience with 25 patients using hypothermic techniques. Ann Thorac Surg 32: 260–272
Crawford ES, Snyder DM (1983) Treatment of aneurysms of the aortic arch: a progress report. J Thorac Cardiovasc Surg 85: 237–246
Mahfood S, Qazi A, Garcia J, Mispireta L, Coaso P, Smyth N (1985) Management of aortic arch aneurysm using profound hypothermia and circulatory arrest. Ann Thorac Surg 39: 412–417
Ueda Y, Miki S, Kusuhara K, Okita Y, Tahara T, Yamanaka K (1990) Surgical treatment of aneurysm of dissection involving the ascending aorta and aortic arch, utilizing circulatory arrest and retrograde cerebral perfusion. J Cardiovasc Surg 31: 553–558
Kubota Y, Akashi H, Aoyagi S, Yamana K, Nishimi M, Uraguchi K, Fujino T, Koga M, Suzuki S, Kenmochi K, Kosuga K, Ohishi K (1990) An experimental study of hypothermic cardiopulmonary bypass with partial brachiocephalic perfusion (in Japanese). J Jpn Assoc Thorac Surg 38: 1975
Coselli JS, Buket S, Djukanovic B (1995) Aortic arch operation: Current treatment and results. Ann Thorac Surg 59: 19–27
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© 1997 Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt
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Akashi, H., Tayama, K., Fukunaga, S., Kosuga, K., Aoyagi, S. (1997). Aortic arch surgery using antegrade selective cerebral perfusion. In: Ennker, J., Coselli, J.S., Treasure, T. (eds) Cerebral Protection in Cerebrovascular and Aortic Surgery. Steinkopff. https://doi.org/10.1007/978-3-642-95987-5_24
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DOI: https://doi.org/10.1007/978-3-642-95987-5_24
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