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Ann Thorac Surg 2003;75:1034-1036
© 2003 The Society of Thoracic Surgeons

How to do it

Aortic arch reconstruction using a trifurcated graft

David Spielvogel, MDa*, Manu N. Mathur, MDa, Steven L. Lansman, MD, PhDa, Randall B. Griepp, MD

a Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, New York, USA

Accepted for publication August 22, 2002.

* Address reprint requests to Dr Spielvogel, Department of Cardiothoracic Surgery, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1028, New York, NY 10029, USA
e-mail: david.spielvogel{at}msnyuhealth.org

Cerebral protection and prevention of atheroembolism remain challenges in aortic arch reconstruction. To reduce neurologic complications, we developed a "no-touch" technique in which a trifurcated graft is anastomosed to the arch vessels during hypothermic circulatory arrest, reducing the risk of embolization while minimizing cerebral ischemia by permitting antegrade cerebral perfusion as arch reconstruction is completed.




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