EndoClamp Aortic Catheter in the descending aorta for normothermic aortic arch replacement on the beating heart without circulatory arrest

Natale, Maurilio Di; Tancredi, Fabrizio; Bachicchio, V; Paternoster, Gianluca; Lentini, Salvatore

doi:10.1177/0267659113486509

Cited by 4 publications

(1 citation statement)

References 12 publications

(23 reference statements)

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“…Once the ascending aortic graft was ready, the distal end of the graft was clamped, and noncardioplegic, continuous blood (25°C) myocardial perfusion (CMP) was initiated via a needle cannula proximal to the clamp. 3,4,6 The CMP flow of around 200 to 250 mL/min was delivered via an independent roller pump, and the myocardial perfusion pressure (MMP) was maintained at 100 to 120 mm Hg 4,7 (►Fig. 1).…”

Section: Operative Proceduresmentioning

confidence: 99%

Continuous Myocardial Perfusion during Distal Anastomosis of Acute Type A Aortic Dissection

Lin

et al. 2023

Thorac Cardiovasc Surg

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Background The effect of continuous myocardial perfusion (CMP) on the surgical results of acute type A aortic dissection (ATAAD) remains unclear. Methods From January 2017 to March 2022, 141 patients who underwent ATAAD (90.8%) or intramural hematoma (9.2%) surgery were reviewed. Fifty-one patients (36.2%) received proximal-first aortic reconstruction and CMP during distal anastomosis. Ninety patients (63.8%) underwent distal-first aortic reconstruction and were placed in traditional cold blood cardioplegic arrest (CA; 4°C, 4:1 blood-to-Plegisol) throughout the procedure. The preoperative presentations and intraoperative details were balanced using inverse probability of treatment weighting (IPTW). Their postoperative morbidity and mortality were analyzed. Results The median age was 60 years. The incidence of arch reconstruction in the unweighted data was higher in the CMP compared with the CA group (74.5 vs 52.2%, p = 0.017) but was balanced after IPTW (62.4 vs 58.9%, p = 0.932, standardized mean difference = 0.073). The median cardiac ischemic time was lower in the CMP group (60.0 vs 130.9 minutes, p < 0.001), but cerebral perfusion time and cardiopulmonary bypass time were similar. The CMP group did not demonstrate any benefit in the reduction of the postoperative maximum creatine kinase-MB ratio (4.4 vs 5.1% in CA, p = 0.437) or postoperative low cardiac output (36.6 vs 24.8%, p = 0.237). Surgical mortality was comparable between groups (15.5% in CMP vs 7.5% in the CA group, p = 0.265). Conclusions Application of CMP during distal anastomosis in ATAAD surgery, irrespective of the extent of aortic reconstruction, reduced myocardial ischemic time but did not improve cardiac outcome or mortality.

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Section: Operative Proceduresmentioning

confidence: 99%