Minimized Mortality and Neurological Complications in Surgery for Chronic Arch Aneurysm:. Axillary Artery Cannulation, Selective Cerebral Perfusion, and Replacement of the Ascending and Total Arch Aorta

Abstract

Continuous perfusion through the axillary artery with selective cerebral perfusion and replacement of the ascending and arch aorta may minimize cerebral complication leading to satisfactory results in patients with chronic aortic aneurysm involving aortic arch.

Aortic Arch Surgery With a Single Centrifugal Pump for Selective Cerebral Perfusion and Systemic Circulation

“…HCA and RCP are relatively simple, but they provide only a limited time (1–3). SCP prolongs the safe circulatory arrest time and improves cerebral cooling; furthermore, it can be used with moderate hypothermia (4,5). Kazui et al.…”

Combined Surgical and Endovascular Approach for the Treatment of Complex Thoracic Aortic Pathologies

“…The arterial cannula is introduced via a short 8-mm Dacron prosthesis, which is anastomosed to the right axillary artery. This permits the surgeon to subsequently perform a safe sternotomy on the one hand, and a means of achieving antegrade cerebral perfusion during circulatory arrest on the other (Strauch et al 2005, Shimazaki et al 2004, Numata et al 2003, Okita et al 2001. (Figure 2) After median sternotomy, a venous two-step cannula is placed in the right atrium and the patient is cooled to 25°C at the heart-lung machine in order to achieve moderate hypothermia (Minatoya et al 2008, Pacini et al 2007).…”

Whole-Body Perfusion under Moderate-Degree Hypothermia during Aortic Arch Repair

“…Shimazaki et al reported 2.5% mild renal dysfunction versus 2.5% liver dysfunction in a mean of 50 minutes cessation of distal aortic perfusion under 28°C [Shimazaki 2004]. In Kucuker's study, postoperative renal and hepatic function tests showed significant difference when compared with the preoperative values, but these were reported to be within normal limits for routine cardiac operations [Kucuker 2005].…”