[Surgery for thoracic aortic aneurysm by retrograde total body perfusion and deep hypothermia]

We performed retrograde total body perfusion and deep hypothermia for DeBakey III aortic dissection and aneurysm of the distal arch. We could operate with only posterolateral skin incision using a long venous cannula, which is originally a part of percutaneous cardiopulmonary support (PCPS). The duration of retrograde total body perfusion was 31-101 minutes, the perfusion volume 0.6-1.4 L/min, the central venous pressure 5-16 mmHg. All five cases were successfully operated. As a postoperative cerebral accident, one case showed transient dysfunction. There was no postoperative liver and renal dysfunction. The perfusion volume was maintained in 2.5-3.0 L/min during ventricular fibrillation, which is occurred in cooling and rewarming process. So, this long venous cannula worked well to assist circulation. We think retrograde total body perfusion is a useful assisting device for DeBakey III aortic dissection and aneurysm of the distal arch.