Open arch-my way! Branch first continuous perfusion arch repair (BF-CPAR)

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Traditional aortic arch repair often necessitates deep hypothermia and circulatory arrest, posing significant risks.
• Cerebral circulatory arrest and deep hypothermia are associated with increased neurological and systemic complications.

Purpose of the Study:

• To present a novel surgical technique, branch first continuous perfusion arch repair (BF-CPAR).
• To demonstrate the applicability of BF-CPAR in various aortic surgeries, including Type A acute aortic dissections.
• To highlight the avoidance of cerebral circulatory arrest and deep hypothermia with this method.

Main Methods:

• The BF-CPAR technique involves continuous perfusion via branches during aortic arch reconstruction.
• This approach facilitates maintaining adequate cerebral perfusion throughout the procedure.
• The technique is applied universally for all aortic surgeries, encompassing complex dissections.

Main Results:

• BF-CPAR successfully eliminates the requirement for cerebral circulatory arrest.
• Deep hypothermia is no longer necessary when employing the BF-CPAR technique.
• The method is effective for a range of aortic pathologies, including acute Type A dissections.

Conclusions:

• The BF-CPAR technique offers a safer alternative for aortic arch repair.
• This innovative approach minimizes the risks associated with traditional methods.
• BF-CPAR is a versatile and effective technique for complex aortic surgeries.