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A strategy for safe sternal reentry in patients with pseudoaneurysms of the ascending aorta using the PORT-ACCESS EndoCPB system

Departments of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA

*Corresponding author. 9500 Euclid Avenue/J4-100, Cleveland, OH 44195, USA. Tel.: +1 (216) 444-2038; fax: +1 (216) 445-3297.

E-mail address: petterg{at}ccf.org (G.B. Pettersson).

Pseudoaneurysms of the ascending aorta developing after previous aortic or aortic valve surgery pose a high risk of exsanguination upon sternal reentry. In the past, femorofemoral bypass and hypothermic circulatory arrest before sternotomy was the preferred approach. Today, however, availability of the PORT-ACCESS EndoCPB system (Edwards Lifesciences, Irvine, CA, USA) allows for endovascular clamping and cardioplegia before sternotomy, avoiding circulatory arrest.

Key Words: Aorta; Aortic valve; Aortic root; Aneurysm; Reoperation