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

This Article Full Text Full Text (PDF) 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): David Spielvogel Christian D. Etz Steven L. Lansman Randall B. Griepp Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Spielvogel, D. Articles by Griepp, R. B. Search for Related Content PubMed PubMed Citation Articles by Spielvogel, D. Articles by Griepp, R. B.

Ann Thorac Surg 2007;83:S791-S795
© 2007 The Society of Thoracic Surgeons

---

Supplement

Aortic Arch Replacement With a Trifurcated Graft

^a Section of Cardiothoracic Surgery, New York College of Medicine, Westchester Medical Center, Valhalla
^b Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, New York

^_* Address correspondence to Dr Spielvogel, Section of Cardiothoracic Surgery, Westchester Medical Center, Valhalla, NY 10595. (Email: spielvogeld{at}wcmc.com).

Presented at Aortic Surgery Symposium X, New York, NY, April 27–28, 2006.

BACKGROUND: The purpose of this study was to review the results of aortic arch replacement using a trifurcated arch graft in conjunction with hypothermic circulatory arrest (HCA) and selective antegrade cerebral perfusion (SCP).

METHODS: One hundred fifty consecutive patients (91 male; mean age, 63 ± 14 years; range, 20 to 87) had aortic arch replacement using a trifurcated arch graft and HCA/SCP from September 1999 to December 2005. The axillary artery was used for cannulation; a trifurcated graft was sewn to the arch vessels during a short interval of HCA; SCP was utilized through the trifurcation graft during the proximal and distal arch repair, and then the trifurcation graft was sewn to the arch graft. Fifty-five patients had chronic dissection; 48 had atherosclerotic and 29 had degenerative aneurysms; 74 had undergone previous cardiac surgery. Isolated arch reconstruction was undertaken in 38 patients: concomitant procedures included ascending aortic replacement in 74; ascending aorta and root replacement in 21; descending replacement in 4, and coronary artery bypass grafting in 36. An elephant trunk was used in 144, but distal to the left subclavian artery in only 87; in 34, it was distal to the left carotid, in 9, it was between the brachiocephalic and left carotid, and in 18, it was proximal to all arch branches. Mean HCA duration was 31.1 ± 6.5 minutes; SCP lasted 66.6 ± 21.0 minutes, at a mean temperature of 15.8 ± 2.1°C.

RESULTS: Adverse outcome occurred in 13 of 150 patients (8.7%): there were 7 hospital deaths and 6 permanent strokes. Temporary neurologic dysfunction was seen in only 7 patients, and renal failure was transient in 9 patients requiring dialysis.

CONCLUSIONS: The use of a trifurcated arch graft with HCA and SCP is a safe and versatile technique for repair of arch aneurysms.

This article has been cited by other articles:

				M. A. Levin, H.-M. Lin, J. G. Castillo, D. H. Adams, D. L. Reich, and G. W. Fischer Early On-Cardiopulmonary Bypass Hypotension and Other Factors Associated With Vasoplegic Syndrome Circulation, October 27, 2009; 120(17): 1664 - 1671. [Abstract] [Full Text] [PDF]

				C. D. Etz, K. A. Plestis, T. M. Homann, C. A. Bodian, G. Di Luozzo, D. Spielvogel, and R. B. Griepp Reoperative aortic root and transverse arch procedures: A comparison with contemporaneous primary operations J. Thorac. Cardiovasc. Surg., October 1, 2008; 136(4): 860 - 867. [Abstract] [Full Text] [PDF]

				J. P. Schwartz, M. Bakhos, A. Patel, S. Botkin, and S. Neragi-Miandoab Impact of pre-existing conditions, age and the length of cardiopulmonary bypass on postoperative outcome after repair of the ascending aorta and aortic arch for aortic aneurysms and dissections Interactive CardioVascular and Thoracic Surgery, October 1, 2008; 7(5): 850 - 854. [Abstract] [Full Text] [PDF]

				T. M. Sundt III, T. A. Orszulak, D. J. Cook, and H. V. Schaff Improving Results of Open Arch Replacement Ann. Thorac. Surg., September 1, 2008; 86(3): 787 - 796. [Abstract] [Full Text] [PDF]

				C. D. Etz, K. A. Plestis, F. A. Kari, M. Luehr, C. A. Bodian, D. Spielvogel, and R. B. Griepp Staged repair of thoracic and thoracoabdominal aortic aneurysms using the elephant trunk technique: a consecutive series of 215 first stage and 120 complete repairs Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 605 - 615. [Abstract] [Full Text] [PDF]

				C. D. Etz, K. A. Plestis, F. A. Kari, D. Silovitz, C. A. Bodian, D. Spielvogel, and R. B. Griepp Axillary Cannulation Significantly Improves Survival and Neurologic Outcome After Atherosclerotic Aneurysm Repair of the Aortic Root and Ascending Aorta Ann. Thorac. Surg., August 1, 2008; 86(2): 441 - 447. [Abstract] [Full Text] [PDF]

				N. Khaladj, M. Shrestha, S. Meck, S. Peterss, H. Kamiya, K. Kallenbach, M. Winterhalter, L. Hoy, A. Haverich, and C. Hagl Hypothermic circulatory arrest with selective antegrade cerebral perfusion in ascending aortic and aortic arch surgery: A risk factor analysis for adverse outcome in 501 patients. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 908 - 914. [Abstract] [Full Text] [PDF]

				H. Kamiya, K. Kallenbach, A. Haverich, and M. Karck Reply to the Editor J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 715 - 716. [Full Text] [PDF]