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Partial brachiocephalic perfusion in aortic arch replacement

S Aoyagi1, H Akashi, Y Kubota

  • 1Second Department of Surgery, Kurume University School of Medicine, Japan.

Surgery Today
|January 1, 1993
PubMed
Summary
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Partial brachiocephalic perfusion during hypothermic cardiopulmonary bypass is a safe and effective technique for aortic arch aneurysm surgery. This method demonstrated no technique-related deaths or neurological complications in 11 patients.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Aneurysmal disease of the aortic arch presents significant surgical challenges.
  • Traditional surgical approaches may involve complex cannulation strategies.

Purpose of the Study:

  • To evaluate the safety and efficacy of partial brachiocephalic perfusion.
  • To assess outcomes in patients undergoing aortic arch aneurysm repair using this specific perfusion technique.

Main Methods:

  • The study included 11 patients (4 men, 7 women; age 26-78 years) undergoing aortic arch or adjacent area replacement.
  • Hypothermic cardiopulmonary bypass (20-23°C) with partial brachiocephalic perfusion was employed.
  • Perfusion was selectively administered via the right axillary artery to the innominate artery at 10 ml/kg/min.

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Main Results:

  • The study involved 11 patients with aortic dissection (10) or aortitis syndrome (1).
  • Operative mortality was 27.3% (3 deaths) due to causes other than the perfusion technique.
  • No neurological complications or deaths directly related to partial brachiocephalic perfusion were observed.

Conclusions:

  • Partial brachiocephalic perfusion under hypothermic cardiopulmonary bypass is a safe and effective method.
  • This technique offers a viable option for surgical repair of aortic arch aneurysms.
  • The absence of neurological complications supports its clinical application.