HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Christopher D. Stone Peter S. Greene Vincent L. Gott Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stone, C. D. Articles by Williams, G. M. Search for Related Content PubMed PubMed Citation Articles by Stone, C. D. Articles by Williams, G. M.

Ann Thorac Surg 1994;57:580-587
© 1994 The Society of Thoracic Surgeons

---

Articles

Single-stage repair of distal aortic arch and thoracoabdominal dissecting aneurysms using aortic tailoring and circulatory arrest

Departments of Vascular and Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, Maryland USA

^_* Address reprint requests to Dr Stone, Department of Cardiac Surgery, The Johns Hopkins Hospital, 600 N Wolfe St, Blalock 618, Baltimore, MD 21205.

The adjuncts of profound hypothermic circulatory arrest and aortic tailoring are combined with standard graft replacement of the noncritical portions of the aorta. This combination permits single-stage replacement of the arch, thoracic, and abdominal aorta in patients with postdissection aneurysm. Reconstruction is begun with repair of the mid to distal aortic arch and Dacron graft replacement of the proximal descending thoracic aorta, usually under profound hypothermic circulatory arrest. The proximal graft is then cannulated and the patient partially warmed while the middle segment is "tailored." Aortic tailoring consists of longitudinal aortotomy and removal of the dissection membrane(s) from the distal third of the descending thoracic aorta to below the renal arteries. The aorta is then closed creating a single channel 2 to 3 cm in diameter and containing the origins of the important intercostal, lumbar, and visceral arteries. A Dacron graft is used to replace the infrarenal segment. Five patients have successfully undergone single-stage, total repair of the aorta including the arch, thoracic, and abdominal segments. All survived without paraplegia or significant visceral ischemia. Follow-up has not shown dilatation of the tailored segment. We believe that reduction in diameter of the tailored aortic segment and thus wall tension, growth of neointima on all luminal aortic surfaces, and active collagen deposition contribute to the success of this procedure.

This article has been cited by other articles:

				M. Mutsuga, Y. Narita, Y. Araki, A. Maekawa, H. Oshima, A. Usui, and Y. Ueda Spinal cord protection during a thoracoabdominal aortic repair for a chronic type B aortic dissection using the aortic tailoring strategy Interact CardioVasc Thorac Surg, July 1, 2010; 11(1): 15 - 19. [Abstract] [Full Text] [PDF]

				K. Matsuyama, Y. Narita, A. Usui, T. Akita, H. Oshima, and Y. Ueda Entry Closure and Aortic Tailoring for Chronic Type B Aortic Dissection Asian Cardiovasc Thorac Ann, June 1, 2008; 16(3): 249 - 251. [Abstract] [Full Text] [PDF]

				Y. Miyamoto, T. Ohata, M. Mitsuno, M. Yamamura, H. Tanaka, Y. Kobayashi, M. Ryomoto, and S. Fukui Long-term outcomes after entry closure and aneurysmal wall plication for type B aortic dissection Eur J Cardiothorac Surg, February 1, 2008; 33(2): 152 - 156. [Abstract] [Full Text] [PDF]

				Y. Moriyama, Y. Iguro, K. Hisatomi, G. Yotsumoto, H. Yamamoto, and R. Toda Thoracic and thoracoabdominal aneurysm repair under deep hypothermia using subclavian arterial perfusion Ann. Thorac. Surg., January 1, 2001; 71(1): 29 - 32. [Abstract] [Full Text] [PDF]