Resection of the ascending aorta using profound local hypothermia for myocardial protection

Resection of the ascending aorta with or without aortic valve replacement requires prolonged interruption of myocardial blood flow. Profound local cardiac hypothermia was used in 8 patients, 5 of whom had simultaneous aortic valve replacement. Three patients with acute dissections were encountered, one with cardiac tamponade secondary to intrapericardial rupture. The duration of aortic cross-clamp time varied from 43 to 122 minutes. There were no complications related to the cooling technique. There were no operative or hospital deaths. One patient died of myocardial infarction at 6 weeks. These results coupled with the experience of others suggest that coronary perfusion during periods of obligatory anoxia in unnecessary. Local cardiac hypothermia offers a satisfactory alternative for myocardial protection during prolonged aortic crossclamping.