Off Pump Repair of Aortic Arch Anomalies With Concomitant Intracardiac Defects Via Anterior Approach

Abstract

Most of the aortic coarctation and interrupted aorta type A can be well-treated surgically through median sternotomy without using CPB. Thus, the need for profound hypothermia and circulatory arrest and its potential neurological and other side effects are removed and CPB is reserved only for associated intracardiac defects, if present.

Aortic Arch Repair: Let It Beat!

“…This would result in less space for correction at the junction between the ascending aorta and aortic arch. Ozkara and colleagues 8 introduced an off-pump variant of AAR via an anterior approach, including resection and end-to-side anastomosis or patch aortoplasty. Subsequently, CPB was used only for the repair of intracardiac defects.…”

“…Different alternative methods for myocardial perfusion, which allow the heart to continue beating during aortic surgery, have been published. [1][2][3][4][5][6][7][8][9][10][11] We perform a sophisticated technique of selective myocardial perfusion (SMP) using an additional 4F-cannula in the proximal ascending aorta connected to a separate roller pump, which results in a beating-heart variant in which coronary and cerebral flow can be regulated during low flow perfusion.…”