Direct cannulation of the common carotid artery during the ascending aortic or aortic arch replacement

Kuniyoshi, Yukio; Koja, Kageharu; Miyagi, Kazufumi; Uezu, Tooru; Yamashiro, Satoshi; Arakaki, Katsuya; Mabuni, Katsuhito; Senaha, Shigenobu

doi:10.1007/s11748-004-0118-8

Cited by 5 publications

(3 citation statements)

References 13 publications

(1 reference statement)

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“…The combined approach seemed to be too invasive for respiratory function. On the other hand, Ohata et al [2] found no significant differences in respiratory function or in the inflammatory response between patients who underwent total arch replacement through a median sternotomy and those who also had a left anterolateral thoracotomy. Especially in the distal reoperative situation for dissecting type A, the retrosternal space can be easily excised from a left thoracotomy, although adhesion due to previous surgeries can be moderate or severe.…”

Section: Discussionmentioning

confidence: 96%

Extended Aortic Replacement Via Median Sternotomy with Left Anterolateral Thoracotomy

Yamashiro¹,

Kuniyoshi²,

Ichikawa³

et al. 2013

Aortic Aneurysm - Recent Advances

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Section: Discussionmentioning

confidence: 96%

Extended Aortic Replacement Via Median Sternotomy with Left Anterolateral Thoracotomy

Yamashiro¹,

Kuniyoshi²,

Ichikawa³

et al. 2013

Aortic Aneurysm - Recent Advances

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“…39 Rylski and colleagues 43 very comprehensively outlined the different cerebral protection strategies in ATAAD surgery complicated by cerebral malperfusion. According to them, carotid artery cannulation, although relatively limited in clinical experience, 45,46 can potentially provide several benefits: easy surgical access; wider and stronger arterial walls compared to the AxA, which makes its cannulation feasible in obese patients requiring high CPB flow; and unlike the axillary and innominate arteries that are only limited to the right side, both the right and left carotid arteries can be cannulated for cerebral perfusion. In the case of carotid dissection, they also emphasized the effectiveness and ease of combining carotid cannulation with a 2nd or 3rd arterial line to ensure both cerebral and systemic perfusion.…”

Section: Cerebral Protection Strategies and Monitoringmentioning

confidence: 99%

Type A aortic dissection: involvement of carotid artery and impact on cerebral malperfusion

Munir

Harky

Bashir

et al. 2020

Asian Cardiovasc Thorac Ann

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Acute type A aortic dissection is a surgical emergency and management of such pathology can be complex with poor outcomes when there is organ malperfusion. Carotid artery involvement is present in 30% of patients diagnosed with acute type A aortic dissection, and given its emergency and complex nature, there is much controversy regarding the approach, extent of treatment, and timing of the intervention. It is clear that the occurrence of cerebral malperfusion adds an extra layer of complexity to the decision-making framework for treatment. Standardization and validation of the optimal management approach is required, and this should ideally be addressed with large-scale studies. Nonetheless, current literature supports the need for rapid recognition and diagnosis of acute type A aortic dissection with cerebral malperfusion, immediate and extensive surgical repair, and the appropriate use of cerebral perfusion techniques. This paper aims to discuss the current evidence regarding the impact of carotid artery involvement in both the management and outcomes of acute type A aortic dissection.

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“…Despite advances in surgical techniques, including anesthesia and cardiopulmonary bypass (CPB), brain injury after aortic arch surgery remains an important source of morbidity and mortality because of the advanced age of the patients and the presence of serious comorbidities. [1][2][3][4][5][6] Extended thoracic aortic aneurysms involving the ascending aorta, arch, and descending aorta are often repaired in staged operations. 7 However, single-stage replacement of the aortic arch and descending aorta might be a preferable surgical option for specific types of atherosclerotic aneurysm such as chronic type A or B dissection.…”

Section: Introductionmentioning

confidence: 99%

Aortic Replacement via Median Sternotomy with Left Anterolateral Thoracotomy

Yamashiro

Kuniyoshi

Arakaki

et al. 2009

Asian Cardiovasc Thorac Ann

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Prevention of cerebral injury is an important consideration during repair of aortic arch aneurysm, and the major goal of cerebral protection techniques. We describe our surgical strategy for treatment of extended thoracic aortic aneurysms. Between January 2001 and June 2008, 17 men and 6 women, with a mean age of 67.9 +/- 8.3 years, underwent total replacement of the arch and descending aorta. Six (26.1%) patients required emergency surgery. A median sternotomy with a left anterolateral thoracotomy provided a good visual field, and bilateral axillary arteries were preferentially used for systemic as well as selective cerebral perfusion. Two (8.7%) patients died in hospital. Prolonged mechanical ventilation was required for 7.3 +/- 8.4 days after surgery in 17 patients who all recovered uneventfully. Permanent neurological dysfunction developed in 1 (4.3%) patient who died of sepsis 2 years after the operation. Our results suggest that total arch replacement through a median sternotomy plus a left anterolateral thoracotomy is helpful for extended replacement of the thoracic aorta as well as distal reoperation for dissecting type A aortic aneurysm. Perfusion via bilateral axillary arteries may improve cerebral protection.

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Direct cannulation of the common carotid artery during the ascending aortic or aortic arch replacement

Abstract: Direct cannulation of the common carotid artery is a simple, safe, and acceptable cerebral protection for patients undergoing aortic or aortic arch replacement procedures in the patients with these specific conditions.

Cited by 5 publications

References 13 publications

Extended Aortic Replacement Via Median Sternotomy with Left Anterolateral Thoracotomy

Extended Aortic Replacement Via Median Sternotomy with Left Anterolateral Thoracotomy

Type A aortic dissection: involvement of carotid artery and impact on cerebral malperfusion

Aortic Replacement via Median Sternotomy with Left Anterolateral Thoracotomy

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