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Ann Thorac Surg 2005;80:1159
© 2005 The Society of Thoracic Surgeons

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Correspondence

Distal Aortic Perfusion During Aortic Arch Repair

Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan

(Email: kfgth973{at}ybb.ne.jp).

To the Editor:

We read with interest the article by Klodell and associates [1] regarding distal aortic perfusion to maintain perfusion of the spinal cord, viscera, and lower extremities during the period of open arch repair. However, this technique is not original; we described the same approach [2] 2 years ago. A 21-French aortic balloon occlusion catheter with a 14-French perfusion lumen (MD-21020 [Sumitomo Bakelite, Tokyo, Japan]) was utilized in 8 patients. During perfusion, a flow rate of 32.9 ± 7.5 mL/min/kg produced a lower extremity pressure of 44.1 ± 12.5 mm Hg and urine output of 0.77 ± 0.44 mL/min/kg. Selective cerebral perfusion and antegrade perfusion of the lower half of the body with the catheter began at a rectal temperature of 25°C in our series. Klodell and associates [1] perfused the distal aorta at the bladder temperature of 18°C even though "double antegrade cerebral perfusion" was used. We believe that distal aortic perfusion of the spinal cord, viscera, and lower extremities avoids the need for deep hypothermia. We appreciate support for distal aortic perfusion during aortic arch repair by Klodell and co-workers [1], and hope that more cardiovascular surgeons have a new understanding of this valuable method.

	References

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1. Klodell CT, Hess PJ, Beaver TM, Clark D, Martin TD. Distal aortic perfusion during aortic arch reconstructionanother tool for the aortic surgeon. Ann Thorac Surg 2004;78:2196-2198.[Abstract/Free Full Text]
2. Takagi H, Mori Y, Iwata H, Umeda Y, Matsuno Y, Hirose H. Aortic balloon occlusion catheter with perfusion lumen for protection of lower body during distal anastomosis in aortic arch repair J Thorac Cardiovasc Surg 2002;123:1006-1008.[Free Full Text]

This article has been cited by other articles:

				C. T. Klodell Distal Aortic Perfusion during Aortic Arch Repair: Reply Ann. Thorac. Surg., September 1, 2005; 80(3): 1159 - 1160. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hisato Takagi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Takagi, H. Articles by Matsuno, Y. Search for Related Content PubMed Articles by Takagi, H. Articles by Matsuno, Y. Related Collections Great vessels Related Article