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Related Experiment Videos

Simultaneous total aortic replacement from valve to bifurcation: experience with 21 cases

C G Massimo1, L F Presenti, P P Favi

  • 1University of Florence, Italy.

The Annals of Thoracic Surgery
|November 1, 1993
PubMed
Summary

This study details a surgical technique for total aortic replacement in patients with complex thoracic and abdominal aortic emergencies. The procedure involves deep hypothermia and cardiopulmonary bypass to manage aortic dissection and aneurysms.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Complex aortic diseases require extensive surgical intervention.
  • Simultaneous thoracic and abdominal aortic emergencies present significant surgical challenges.
  • Aortic regurgitation and dissection are common indications for extensive aortic repair.

Purpose of the Study:

  • To describe a surgical technique for total aortic replacement from the valve to the bifurcation.
  • To evaluate the management of patients with combined thoracic and abdominal aortic emergencies.
  • To present outcomes of a surgical approach using deep hypothermia and cardiopulmonary bypass.

Main Methods:

  • Retrospective review of 21 patients undergoing total aortic replacement (June 1985-December 1991).

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  • Surgical technique involved deep hypothermia, cardiopulmonary bypass, aortic root replacement, and extended aortic replacement.
  • Patient evaluation included computed tomography, magnetic resonance imaging, and angiography.

    • Main Results:

    • The study included 21 patients (12 men, 9 women; mean age 60) with aortic dilatation, aneurysms, or dissection.
    • Indications included cardiac compromise from aortic regurgitation and impending rupture with visceral/limb ischemia.
    • Deep hypothermia at electroencephalographic silence ranged from 14°C to 19°C.

    Conclusions:

    • Total aortic replacement from valve to bifurcation is feasible for complex thoracic and abdominal aortic emergencies.
    • Deep hypothermia and cardiopulmonary bypass are critical components of this extensive surgical procedure.
    • Modifications to the technique, such as reduced operating time during cooling, were explored in later cases.