Alternative perfusion technique without axillary artery cannulation during combined aortic root and total arch...

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Thoracic Surgery

Background:

• Redo aortic root reconstruction and total aortic arch replacement are complex procedures.
• Maintaining adequate cerebral perfusion during these surgeries is critical for patient outcomes.
• Standard perfusion methods may be challenging in redo cases due to anatomical variations or previous interventions.

Observation:

• A technique utilizing an additional 4th side limb graft attached to a trifurcated graft was employed.
• This method was applied in patients undergoing redo aortic root reconstruction with total aortic arch replacement.
• The technique was particularly useful when the innominate artery origin was unsuitable for clamping or axillary perfusion was not feasible.

Findings:

• The described cerebral perfusion method effectively provides continuous brain protection.
• This approach successfully minimizes the duration of circulatory arrest.
• It offers a viable alternative perfusion strategy in challenging aortic surgical scenarios.

Implications:

• This technique can improve safety and outcomes for patients undergoing complex aortic arch surgery.
• It provides a reliable method for cerebral protection when conventional approaches are limited.
• Further adoption of this method could standardize brain protection strategies in redo aortic surgeries.