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Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion

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Improved brain and myocardial protection during complex aortic reinterventions.

Marco Di Eusanio¹, Carlo Savini, Gianluca Folesani

¹Department of Cardiac Surgery, S'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. marco.dieusanio2@unibo.it

The Annals of Thoracic Surgery

|January 1, 2013

Summary

Redo aortic surgery poses challenges for brain and myocardial protection, especially with sternal adhesions and severe aortic valve regurgitation. This technique uses antegrade brain perfusion and left ventricle apex venting for improved patient outcomes.

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Area of Science:

Cardiovascular Surgery
Thoracic Surgery
Aortic Surgery

Background:

Redo aortic surgery presents significant challenges, particularly concerning brain and myocardial protection.
Patients with large aneurysms adherent to the sternum and severe aortic valve regurgitation require specialized surgical approaches.

Purpose of the Study:

To present a novel surgical technique for redo aortic surgery.
To address the critical issues of brain and myocardial protection in complex cases.

Main Methods:

The technique involves antegrade cerebral perfusion initiated prior to resternotomy.
Left ventricle venting is achieved through the apex via a small anterolateral thoracotomy.

Main Results:

This approach aims to enhance brain and myocardial protection during complex redo aortic procedures.
The described method offers a potential solution for managing challenging patient anatomies.

Conclusions:

The presented technique offers a viable strategy for improving safety in redo aortic surgery.
This method may be particularly beneficial for patients with sternal adhesions and severe aortic valve regurgitation.