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Ann Thorac Surg 1995;60:352-353
© 1995 The Society of Thoracic Surgeons

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Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 345.

DR SAFUH ATTAR (Baltimore, MD): I congratulate Dr Bavaria and his associates on their solution to this very complicated problem. In our experience, cerebral perfusion, whether antegrade or retrograde, is indicated only when the transverse arch is involved by aneurysmal dissection. There is no need for cerebral perfusion in ascending aortic aneurysms, whether it is dissecting or not.

As far as the descending thoracic aortic aneurysms, our results compare with those of Dr Crawford and are about the same as yours. We have had 87 patients undergoing resection of the descending thoracic aortic aneurysms; 61 had acute traumatic aortic ruptures and 26 chronic aortic aneurysms. Among the acute traumatic ruptures, 22 were resected without shunt with a cross-clamp time of 41 minutes; 31 patients were shunted with a cross-clamp time of 74 minutes. In the chronic aneurysms, 13 had adjunctive support with a cross-clamp time of 22 minutes (these include thoracic and thoracoabdominal aortic aneurysms), and 13 patients had shunt and bypass with a cross-clamp time of 45 minutes. The paraplegia without shunt occurred in 4 of 22 with traumatic aortic rupture, an incidence of 17%, with the shunt it occurred in 6 of 39, which is 15%; in other words, no difference. In patients with chronic aortic aneurysms it occurred in 1 of 13, that is 7%, with or without shunt; the rates were . . . [Full Text of this Article]

Related Article

Retrograde Cerebral and Distal Aortic Perfusion During Ascending and Thoracoabdominal Aortic Operations

Joseph E. Bavaria, Y. Joseph Woo, R. Alan Hall, Jeffrey P. Carpenter, and Timothy J. Gardner
Ann. Thorac. Surg. 1995 60: 345-352. [Abstract] [Full Text]

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