Aortic Arch-Clamping Technique in Hemiarch Replacement Without Circulatory Arrest

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• The open anastomosis technique is prevalent for hemiarch replacement but necessitates hypothermic circulatory arrest.
• Hypothermic circulatory arrest carries inherent risks and complications.

Purpose of the Study:

• To introduce and evaluate a novel surgical technique, the arch-clamping technique.
• To determine the efficacy and safety of the arch-clamping technique in patients with ascending aortic aneurysms extending to the aortic arch.
• To assess the feasibility of avoiding hypothermic circulatory arrest during hemiarch replacement.

Main Methods:

• A cohort of thirty patients underwent hemiarch replacement using the arch-clamping technique between 2021 and 2022.
• The arch-clamping technique was applied to patients with ascending aortic aneurysms involving the proximal aortic arch.
• Surgical outcomes and patient recovery were monitored.

Main Results:

• The arch-clamping technique successfully facilitated hemiarch replacement in all thirty patients.
• The procedure avoided the need for hypothermic circulatory arrest.
• All thirty patients were discharged uneventfully, indicating a safe and effective outcome.

Conclusions:

• The arch-clamping technique represents a viable and safe alternative for hemiarch replacement in selected patients.
• This novel approach eliminates the requirement for hypothermic circulatory arrest, potentially reducing associated risks.
• The technique shows significant promise for treating ascending aortic aneurysms extending to the aortic arch.