An Alternative Technique for Hemiarch Replacement Without Using Deep Hypothermic Circulatory Arrest.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Ascending aortic aneurysms extending into the aortic arch require complex surgical repair.
• Traditional hemiarch replacement often necessitates hypothermic circulatory arrest, carrying significant risks.
• Minimally invasive approaches are sought to improve patient outcomes and reduce complications.

Purpose of the Study:

• To describe an alternative technique for aortic hemiarch replacement.
• To evaluate the safety and efficacy of axillary cannulation and arch vessel isolation for hemiarch reconstruction.
• To determine the feasibility of avoiding hypothermic circulatory arrest during these procedures.

Main Methods:

• A novel surgical technique involving right axillary artery cannulation was employed.
• Isolation and clamping of the innominate artery were performed, along with tangential aortic clamping.
• The procedure focused on hemiarch reconstruction in patients with ascending aortic aneurysms.

Main Results:

• Three patients successfully underwent aortic hemiarch reconstruction using the described technique.
• No instances of neurologic events were observed postoperatively.
• Zero perioperative morbidity and mortality were recorded in the patient cohort.

Conclusions:

• Axillary cannulation and arch vessel isolation offer a viable alternative to hypothermic circulatory arrest for aortic hemiarch replacement.
• This technique appears to be safe and effective, with excellent early outcomes.
• Further research with larger cohorts is warranted to confirm these findings.