A centrifugal pump for graft replacement of the descending thoracic or thoraco-abdominal aorta

Between January 1987, and December 1988, 14 cases of descending thoracic or thoraco-abdominal aortic aneurysm underwent operation using a prosthetic graft replacement. In order to avoid hypoperfusion to distal organs and proximal hypertension during aortic cross-clamping, two different adjuncts were used and the effectiveness of those methods were compared according to the results of surgery. Seven patients were treated with a temporary shunt of heparin-bonded tube from the left axillary artery to left femoral artery, or else Dacron vascular prosthesis from right axillary artery to right femoral artery (Group I). In Group II (seven patients), left heart bypass was performed, using a centrifugal pump from the left atrium to the left femoral artery with minimal heparinization. In Group I, there were two hospital deaths, due to respiratory and hepatic failure respectively, and paraplegia has occurred in one case. In Group II, there was no death during a post-operative observation period of 5-15 months, and there was no case of paraplegia. We think that temporary left heart bypass with a centrifugal pump seems to be the most useful method today for graft replacement of the descending thoracic or thoraco-abdominal aorta.