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Correspondence

Reply

University of Miami Miller School of Medicine and Jackson Memorial Hospital, 1611 NW 12th Ave, East Tower 3072 (R-114), Miami, FL 33136

To the Editor:

We thank Drs Marcano and Garcia-Rinaldi [1] for their comments regarding the modified Cabrol shunt to control hemorrhage during complex ascending aortic surgery [2]. Credit should go to Cabrol and colleagues [3] who first reported their original contribution related to a challenging and humbling subject (ie, uncontrollable bleeding during surgery for ascending aortic aneurysm). The technique for dealing with this type of aortic disease process has evolved over the years. Total resection of the aneurysm is now routinely advocated, which potentially eliminates late complications such as false aneurysm formation, infection, and others. However, the surgeon can find himself/herself with troublesome bleeding from inaccessible areas. This may be the case when uncontrollable bleeding occurs at the proximal anastomosis during a Bentall or Cabrol aortic root reconstructive procedure. When the aneurysmal shell has been removed, the modified Cabrol shunt may help with dealing with this troublesome complication. What happens to the shunt later on in the patient's course has not been a problem, as most of them tend to close. We have not had to reoperate on any of these patients. In our view, the Cabrol shunt has been an invaluable contribution to controlling hemorrhage in major aortic surgery when everything else fails.

	References

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1. Marcano HE, Garcia-Rinaldi R. Modified Cabrol shunt for uncontrollable hemorrhage after replacement of the aortic valve and ascending aorta (letter) Ann Thorac Surg 2009;87:1324.[Free Full Text]
2. Salerno TA, Carvalho EM, Panos AL, Ricci M. Modified Cabrol shunt after complex aortic surgery Ann Thorac Surg 2008;86:669-670.[Abstract/Free Full Text]
3. Cabrol C, Pavie A, Gandjbakhch I, et al. Complete replacement of the ascending aorta with reimplantation of the coronary arteries. New surgical approach. J Thorac Cardiovasc Surg 1981;81:309-315.[Abstract]

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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Tomas Salerno Marco Ricci Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Salerno, T. Articles by Ricci, M. Search for Related Content PubMed PubMed Citation Articles by Salerno, T. Articles by Ricci, M. Related Collections Related Article