Hypothermic circulatory arrest in the treatment of thoracic aortic lesions

The use of hypothermic circulatory arrest has been established in the treatment of aortic arch lesions. We recently used this method of arrest in the treatment of 10 consecutive patients with thoracic aortic lesions. Seven of these patients had dissecting aneurysms of the ascending aorta with extension into the aortic arch. One patient had a mycotic aneurysm of the arch, and 2 patients had arteriosclerotic aneurysms of the ascending aorta and entire aortic arch. All patients were supported and cooled with cardiopulmonary bypass. Circulatory arrest was maintained for periods of 21 to 63 minutes. All 10 patients survived the operative procedure. Nine patients remained intact neurologically. Renal function returned to baseline in all patients. Average blood replacement was 2.9 units. All patients have experienced an excellent surgical result. The average follow-up is 21.1 months. The technique facilitates a surgical approach to these lesions and appears to be the safest form of vital-organ preservation.