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Retrograde cerebral perfusion through antero-axillary thoracotomy in the aortic arch surgery
S Sasaguri1, S Yamamoto, T Fukuda
1Department of Thoracic and Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
Objective:
We have recently found that left antero-axillary thoracotomy provides an ideal view of aortic arch and makes the direct cannulation to superior vena cava possible for retrograde cerebral perfusion during circulatory arrest.
Method:
Twelve patients with distal aortic arch aneurysm or aortic dissection underwent the repair of aortic arch through this approach. Mean duration of retrograde cerebral perfusion was 41 min.
Results:
Two hospital deaths occurred due to respiratory failure and stroke. The remaining patients survived without any neurological deficits.
Conclusion:
Antero-axillary thoracotomy may be an ideal approach which combines the advantages of median sternotomy and postero-lateral thoracotomy.