A modified procedure in aortic arch replacement with no deep hypothermic circulatory arrest

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Deep hypothermia and circulatory arrest are standard but high-risk procedures during total aortic arch replacement.
• Conventional methods for aortic arch surgery are associated with significant morbidity and mortality rates.

Purpose of the Study:

• To present a modified surgical technique for total aortic arch replacement that aims to eliminate the need for deep hypothermia and circulatory arrest.
• To evaluate the feasibility and early outcomes of the "branch-first" technique combined with a stented elephant trunk.

Main Methods:

• The study employed the "branch-first" surgical approach, integrating distal aortic clamping.
• A stented elephant trunk prosthesis was incorporated to facilitate cerebral and visceral perfusion.
• This technique was utilized during total aortic arch replacement procedures.

Main Results:

• The "branch-first" technique successfully avoided the necessity of deep hypothermia and circulatory arrest.
• The method facilitates aortic arch reconstruction while maintaining perfusion to vital organs.
• Early clinical outcomes associated with this innovative approach are encouraging.

Conclusions:

• The "branch-first" technique represents a significant advancement in total aortic arch replacement surgery.
• This method offers a potentially safer alternative to conventional procedures, reducing the risks of deep hypothermia and circulatory arrest.
• Further investigation and long-term follow-up are warranted to fully establish the benefits of this technique.