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Partial clamping of the brachiocephalic trunk for total ascending aorta replacement without circulatory arrest: early and midterm results
- Source :
- Scopus-Elsevier
- Publication Year :
- 2004
-
Abstract
- BACKGROUND The aim of this study was to evaluate in elective patients the early and midterm results of partial clamping of the brachiocephalic trunk (BCT) for total ascending aorta replacement (TAAR) without circulatory arrest. Contraindications to the procedure were BCT/aortic arch calcifications and chronic aortic dissection. METHODS The right radial artery was cannulated to monitor the systemic pressure after the BCT was partially clamped. A specially designed clamp was applied obliquely to occlude approximately 50% of the BCT and part of the aortic arch. The distal tip of the clamp was positioned in front of the left subclavian artery. From January 2002 to October 2003, 92 patients underwent TAAR. In 62 patients (67.4%), partial clamping of the BCT was used. Twenty of these patients underwent isolated TAAR, 27 underwent aortic valve replacement and TAAR, 11 had a Bentall operation, and 2 had a Cabrol operation. The aortic valve was spared in the remaining 2 patients. The mean (+/- SD) aortic cross-clamping and cardiopulmonary bypass times were 96 +/- 31 minutes and 116 +/- 43 minutes, respectively. RESULTS Early mortality was 1.6% (1 patient). No cerebrovascular accidents occurred, demonstrating the safety of the technique. The major complications were acute respiratory insufficiency in 2 cases and acute renal failure in 5. The mean follow-up time was 9.0 +/- 6.5 months. The mean 18- month and event-free survival rate was 96.6% +/- 0.9%. CONCLUSION Partial clamping of the BCT for TAAR without circulatory arrest provides good early and midterm clinical results. Aortic arch clamping is not associated with cerebrovascular accidents.
- Subjects :
- Aortic valve
Aortic arch
Male
medicine.medical_specialty
law.invention
Aortic valve replacement
law
medicine.artery
Internal medicine
Ascending aorta
medicine
Cardiopulmonary bypass
Humans
Longitudinal Studies
Coronary Artery Bypass
Survival rate
Aorta
Brachiocephalic Trunk
Aortic dissection
business.industry
Middle Aged
medicine.disease
Surgery
medicine.anatomical_structure
Circulatory system
Cardiology
Heart Arrest, Induced
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15226662
- Volume :
- 7
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The heart surgery forum
- Accession number :
- edsair.doi.dedup.....aad267bb41844b2b1ce42e69419d66d0