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[Aortic arch operation under deep hypothermic circulatory arrest].

Li-Ming Wang1, Xin Chen, Kai-Hu Shi

  • 1Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China.

Zhonghua Yi Xue Za Zhi
|June 4, 2009
PubMed
Summary

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Deep hypothermic circulatory arrest aids complex aortic arch surgeries for aneurysms and dissections. This surgical approach aims to reduce mortality and morbidity in patients with these serious aortic conditions.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Context:

  • Aortic arch pathologies, including dissection and aneurysms, present significant surgical challenges.
  • Deep hypothermic circulatory arrest (DHCA) is a critical technique for complex aortic arch operations.
  • Selective cerebral perfusion (SCP) is often employed with DHCA to protect brain function.

Purpose:

  • To review the surgical outcomes of 22 patients undergoing aortic arch operations.
  • To evaluate the efficacy and safety of deep hypothermic circulatory arrest in managing aortic arch diseases.
  • To analyze the different surgical techniques employed for aortic arch repair.

Summary:

  • Twenty-two patients with aortic dissection or aneurysm involving the aortic arch underwent surgery using DHCA.

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  • Procedures included various aortic arch replacements and elephant trunk techniques, with concomitant procedures in some cases.
  • The peri-operative mortality rate was 13.6%, with complications including bleeding, multi-organ failure, and delayed awareness.

    • Impact:

    • DHCA with SCP facilitates complex aortic arch operations, potentially reducing mortality and morbidity.
    • The choice of surgical procedure is tailored to the specific aortic lesion and its extent.
    • This experience highlights the feasibility of managing challenging aortic arch conditions with DHCA.