This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A Bockeria Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. A Articles by Rychin, S. V Search for Related Content PubMed Articles by Bockeria, L. A Articles by Rychin, S. V Related Collections Related Article

Aortic arch replacement

Bakoulev Scientific Center for Cardiovascular Surgery, Roublevskoye Shosse 135, 121552 Moscow, Russia

Repair of aortic arch and the impact of cross-clamping time, New York Heart Association stage, circulatory arrest time, and age on operative outcome

These are good results in aortic arch replacement [1]. Impressive low intraoperative (3%) and hospital mortality (6.2%), few incidences of neurologic adverse events (9%) and nice follow up results. The research has revealed a correlation with results of operation with the NYHA stage and age of the patients. However, it is well known that both the method used for cerebral protection during aortic arch repair and the operative technique for aortic arch reconstruction significantly influence operative outcome in patients undergoing repair of aortic arch aneurysms [2]. The operative technique used by the authors for aortic arch replacement with the use of a prefabricated trifurcated Hemashield graft (Boston Scientific, Wayne, NJ) has allowed them to considerably reduce the time of circulatory arrest and has simplified the antegrade selective cerebral perfusion. In such a situation the greatest prognostic importance for the results of an aortic arch replacement is a preoperation NYHA stage and the age of the patient.

We have pretty long and large experience in surgical treatment of aortic arch aneurysm. In all cases, en bloc technique to reimplant the arch vessels was used and various methods of brain protection (profound hypothermic circulatory arrest, retrograde cerebral perfusion, and antegrade selective cerebral perfusion). It seems obvious now that unilateral antegrade cerebral perfusion has allowed us to simplify the technique of brain protection and significantly lower incidence of neurologic complications.

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1. Schwartz JP, Bakhos M, Patel A, Botkin S, Neragi-Miandoab S. Repair of aortic arch and the impact of cross clamping time, New York Heart Association stage, circulatory arrest time, and age on operative outcome. Interact CardioVasc Thorac Surg 2008;7:425–429.[Abstract/Free Full Text]
2. Kazui T, Washiyama N, Muhammad BAH, Terada H, Yamashita K, Takinami M, Tamiya Y. Total arch replacement using aortic arch branched grafts with the aid of antegrade selective cerebral perfusion. Ann Thorac Surg 2000;70:3–9.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A Bockeria Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. A Articles by Rychin, S. V Search for Related Content PubMed Articles by Bockeria, L. A Articles by Rychin, S. V Related Collections Related Article