The frozen elephant trunk procedure is associated with the occlusion of most (two-thirds) of the intercostal arteries. Maintenance of adequate blood flow in the subclavian and iliac arteries is an integral prerequisite for a favourable outcome. The level of the deployment of the distal edge of the stent graft does not play a defining role.
На сегодняшний день существуют различные подхо-ды в лечении аневризм грудной аорты (ГА) в зависимо-сти от анатомии аневризмы, в том числе аневризм вос-ходящей аорты с переходом на проксимальную часть ду-ги аорты. Так, ряд авторов [1] считают целесообразным выполнение протезирования восходящего отдела аорты (ВоА) с одновременной экзоаллопластикой дуги аорты, проведение гибридного лечения, сочетающего открытую реконструкцию восходящей аорты и эндоваскулярный этап для дуги и нисходящей аорты [2] Results of radical reconstruction of thoracic aortic aneurysms using «Hemiarch» technique Выводы. Реконструкция аневризм ГА по методике hemi-arch в условиях правосторонней унилатеральной антеградной перфузии является оправданной хирургической стратегией у данных пациентов.
Ключевые слова: грудная аорта, аневризма, методика hemi-arch, перфузия головного мозга, брахицефальный ствол.Aim -to estimate the immediate results after «Hemiarch» surgery.Material and methods. 25 patients with thoracic aorta disease were operated. 20 (80%) patients underwent «Hemiarch» surgery, 5 (20%) -«retrograde Hemiarch». The operation was performed under cardiopulmonary bypass (CPB), circulatory arrest (CA) with moderate hypothermia (25-28 °С) and unilateral antegrade cerebral perfusion via the brachiocephalic trunk.Results. CPB duration, aortic cross-clamping and arrest duration were 200.5±62.4, 109.7±49 and 23.7±4.4 minutes respectively. Right hemisphere perfusion was not accompanied by deficiency of blood supply in the left hemisphere. Cerebral oxygen saturation during the operation was 63-73%. In 1 (4%) case bilateral perfusion was required. It was noted resternotomy for bleeding and transient neurological deficit by 1 (4%) case. There were no strokes and coma. Hospital and 30-day mortality was absent.Conclusions. Reconstruction of thoracic aortic aneurysms using «Hemiarch» technique under right-sided unilateral antegrade perfusion is justified surgical strategy in these patients.
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