| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2007;83:S805-S810
© 2007 The Society of Thoracic Surgeons
a Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka
b Department of Thoracic Surgery, Fujita Health University, Aichi, Japan
* Address correspondence to Dr Sasaki, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. (Email: hmsasaki{at}hsp.ncvc.go.jp).
Presented at Aortic Surgery Symposium X, New York, NY, April 27–28, 2006.
BACKGROUND: The purpose of this study was to evaluate the recent outcome of integrated total arch replacement using antegrade selective cerebral perfusion with right axillary artery perfusion.
METHODS: Between 2000 and 2005, 305 patients underwent elective total arch replacement for arch or distal arch aneurysm using a Dacron (DuPont, Wilmington, DE) quadrifurcated prosthesis through a median sternotomy. There were 34 dissecting and 271 nondissecting aneurysms. Brain protection was standardized using antegrade selective cerebral perfusion with right axillary artery cannulation at 20° to 28°C. Risk factors for early mortality and neurologic complications were investigated using multivariate logistic regression analyses.
RESULTS: The durations of hypothermic circulatory arrest, myocardial ischemia, selective cerebral perfusion, cardiopulmonary bypass, and surgery were 60.9 ± 16.8, 125.2 ± 39.3, 150.1 ± 39.0, 229.8 ± 91.4, and 466.4 ± 175.8 minutes, respectively. Seven patients died, for a 2.3% early mortality. Permanent neurologic dysfunction developed in 5 patients (1.6%), and temporary neurologic dysfunction in 20 (6.6%). The mid-term survival rate was 94.6% ± 1.5% at 3 years. On multivariate analyses, prolonged surgery was a risk factor for early mortality. Preoperative cerebral hypoperfusion was a significant determinant for temporary neurologic dysfunction and male gender for permanent neurologic dysfunction.
CONCLUSIONS: Integrated total arch replacement using antegrade selective cerebral perfusion with right axillary artery cannulation yields a favorable outcome with low mortality and cerebral morbidity rates.
This article has been cited by other articles:
|
|
 |
|
  WRITING COMMITTEE MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al. Special Article: 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine Anesth. Analg., August 1, 2010; 111(2): 279 - 315. [Full Text] [PDF]
|
|
|
|
 |
|
 American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society of Interventional Radiology, Society of Thoracic Surgeons, Society for Vascular Medicine, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease J. Am. Coll. Cardiol., April 6, 2010; 55(14): e27 - e129. [Full Text] [PDF]
|
|
|
|
|
|
American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society of Interventional Radiology, Society of Thoracic Surgeons, Society for Vascular Medicine, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary J. Am. Coll. Cardiol., April 6, 2010; 55(14): 1509 - 1544. [Full Text] [PDF]
|
|
|
|
 |
|
 WRITING GROUP MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine Circulation, April 6, 2010; 121(13): e266 - e369. [Full Text] [PDF]
|
|
|
|
|
|
WRITING COMMITTEE MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine Circulation, April 6, 2010; 121(13): 1544 - 1579. [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Reich Central Nervous System Protection in Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2010; 14(1): 32 - 37. [Abstract] [PDF]
|
|
|
|
 |
|
 H. Takayama, C. R. Smith, M. E. Bowdish, and A. S. Stewart Open distal anastomosis in aortic root replacement using axillary cannulation and moderate hypothermia. J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1450 - 1453. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Miyamoto, S. Fukui, T. Kajiyama, M. Mitsuno, M. Yamamura, H. Tanaka, M. Ryomoto, and H. Nishi Analysis of collateral blood flow to the lower body during selective cerebral perfusion: is three-vessel perfusion better than two-vessel perfusion? Eur J Cardiothorac Surg, April 1, 2009; 35(4): 684 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Malvindi, G. Scrascia, and N. Vitale Is unilateral antegrade cerebral perfusion equivalent to bilateral cerebral perfusion for patients undergoing aortic arch surgery? Interact CardioVasc Thorac Surg, October 1, 2008; 7(5): 891 - 897. [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]
|
|
|
|
|
|
H. Watanuki, H. Ogino, K. Minatoya, H. Matsuda, H. Sasaki, M. Ando, and S. Kitamura Is Emergency Total Arch Replacement With a Modified Elephant Trunk Technique Justified for Acute Type A Aortic Dissection? Ann. Thorac. Surg., November 1, 2007; 84(5): 1585 - 1591. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
