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

This Article 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 Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Minale, C. Articles by Reifschneider, H. J. Search for Related Content PubMed PubMed Citation Articles by Minale, C. Articles by Reifschneider, H. J.

The Annals of Thoracic Surgery, Vol 57, 850-855, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Replacement of the entire thoracic aorta in a single stage

C Minale, FH Splittgerber and HJ Reifschneider
Department of Cardiothoracic and Vascular Surgery, University of Witten- Herdecke, Wuppertal Heart Center, Germany.

Aneurysms of the entire thoracic aorta are usually approached in two to three stages. From 1990 to 1992, we performed one-stage aortic replacement from the root to the diaphragm in 12 patients (7 men, 5 women; median age, 51 years; range, 49 to 73 years). There were 9 type A dissections, 5 of which were acute. Five patients underwent aortic valve reconstruction, and 5 had aortic root replacement by Bentall or Cabrol techniques. In 2 patients the innominate artery had to be replaced by a vascular graft separately, in addition to reimplantation of the supraaortic branches as an island flap into the arch prosthesis. In 5 patients a mid-sternotomy was used; in 7 a bilateral transverse thoracotomy. The procedure was performed under deep hypothermic circulatory arrest in all cases (median, 45 minutes). Two patients, both operated on for an acute dissection, died perioperatively: 1 due to a bronchopneumonia, 1 because of a thrombosed Cabrol graft to the right coronary artery. No bleeding or neurologic complications developed. At a median follow-up of 14 months (range, 1 to 33 months), all patients discharged from the hospital were still alive. Four patients underwent subsequent thoracoabdominal aortic replacement. This experience suggests that complete thoracic aortic replacement can be performed in a single session, with an operative risk comparable with that of the conventional two-stage approach. The bilateral transverse thoracotomy affords an excellent exposure. The lack of spinal cord ischemia may be the result of spinal cord protection with hypothermic circulatory arrest and the open clamp technique.

This article has been cited by other articles:

				K. Toda, K. Taniguchi, H. Hata, Y. Shudo, H. Matsue, S. Kuki, and Y. Sawa Single-stage repair of arch aneurysms with a long elephant trunk: Medium-term follow-up of thromboexcluded aneurysms J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 47 - 52. [Abstract] [Full Text] [PDF]

				M. A. Pichlmaier, O. E. Teebken, H. Baraki, and A. Haverich The frozen elephant trunk technique MMCTS, March 29, 2007; 2007(0329): 1990. [Abstract] [Full Text] [PDF]

				H. Baraki, C. Hagl, N. Khaladj, K. Kallenbach, J. Weidemann, A. Haverich, and M. Karck The Frozen Elephant Trunk Technique for Treatment of Thoracic Aortic Aneurysms Ann. Thorac. Surg., February 1, 2007; 83(2): S819 - S823. [Abstract] [Full Text] [PDF]

				J. S. Coselli, S. A. LeMaire, S. A. Carter, and L. D. Conklin The Reversed Elephant Trunk Technique Used for Treatment of Complex Aneurysms of the Entire Thoracic Aorta Ann. Thorac. Surg., December 1, 2005; 80(6): 2166 - 2172. [Abstract] [Full Text] [PDF]

				M. Doss, T. Woehleke, J. P. Wood, S. Martens, G. W. Greinecker, and A. Moritz The clamshell approach for the treatment of extensive thoracic aortic disease J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 814 - 817. [Abstract] [Full Text] [PDF]

				T. Ohata, T. Sakakibara, H. Takano, and T. Ishizaka Total arch replacement for thoracic aortic aneurysm via median sternotomy with or without left anterolateral thoracotomy Ann. Thorac. Surg., June 1, 2003; 75(6): 1792 - 1796. [Abstract] [Full Text] [PDF]

				N. T. Kouchoukos, P. Masetti, and C. K. Rokkas Single-stage replacement of the thoracic aorta Ann. Thorac. Surg., October 1, 2002; 74(4): 1292 - 1292. [Full Text] [PDF]

				H. Ishihara, N. Uchida, C. Yamasaki, M. Sakashita, and M. Kanou Extensive primary repair of the thoracic aorta in Stanford type A acute aortic dissection by means of a synthetic vascular graft with a self-expandable stent J. Thorac. Cardiovasc. Surg., June 1, 2002; 123(6): 1035 - 1040. [Abstract] [Full Text] [PDF]

				H. J. Safi, C. C. Miller III, A. L. Estrera, T. T.T. Huynh, F. S. Rubenstein, M. H. Subramaniam, and L. M. Buja Staged Repair of Extensive Aortic Aneurysms: Morbidity and Mortality in the Elephant Trunk Technique Circulation, December 11, 2001; 104(24): 2938 - 2942. [Abstract] [Full Text] [PDF]

				T. M. Beaver and T. D. Martin Single-stage transmediastinal replacement of the ascending, arch, and descending thoracic aorta Ann. Thorac. Surg., October 1, 2001; 72(4): 1232 - 1238. [Abstract] [Full Text] [PDF]

				T. Kunihara, N. Shiiya, Y. Kamikubo, Y. Matsui, and K. Yasuda Midline exposure of the thoracoabdominal aorta Ann. Thorac. Surg., June 1, 2000; 69(6): 1951 - 1953. [Abstract] [Full Text] [PDF]

				N. T. Kouchoukos and C. K. Rokkas Arch-first technique through left antero-axillary thoracotomy or bilateral anterior thoracotomy J. Thorac. Cardiovasc. Surg., July 1, 1999; 118(1): 208 - 209. [Full Text]

				C. K. Rokkas and N. T. Kouchoukos SINGLE-STAGE EXTENSIVE REPLACEMENT OF THE THORACIC AORTA: THE ARCH-FIRST TECHNIQUE J. Thorac. Cardiovasc. Surg., January 1, 1999; 117(1): 99 - 105. [Abstract] [Full Text] [PDF]