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Correspondence

Technique of Cannulation and Body Perfusion During Aortic Arch Repair

Department of Cardiothoracic Surgery, Second University of Naples, A.O. Monaldi, Via L. Bianchi, Napoli, 80131 Italy

(Email: gianantonio.nappi{at}unina2.it).

To the Editor:

In their article, Panos and colleagues [1] claim a "novel technique for aortic arch surgery." The authors probably were unaware that our group has described exactly the same technique in detail on several occasions [2–4].

I have two comments for the authors. First, in our experience, perioperative, bilateral, transcranial Doppler monitoring of middle cerebral arterial flow is not required to monitor perfusion of the contralateral cerebral hemisphere. This procedure can be troublesome during an emergency operation for acute aortic dissection. The same information can be obtained by observing the amount of blood returning from the left carotid artery before clamping [3]. Second, we used an 8-mm cuffed endotracheal cannula, which is significantly smaller than that used by Panos and colleagues and has negligible effects by itself on the blood flowing through the cannulae to the descending thoracic aorta.

We believe that this is a simple, safe, and effective technique for aortic arch operations and ensures antegrade perfusion at full flow for the entire body during moderate hypothermia.

	References

Top References

 

1. Panos A, Myers PO, Kalangos A. Novel technique for aortic arch surgery under mild hypothermia Ann Thorac Surg 2008;85:347-348.[Abstract/Free Full Text]
2. Nappi G, Maresca L. Total Antegrade body perfusion in the treatment of type A acute aortic dissection. Proceedings of the Aortic Surgery Symposium IX, New York, NY, April 22–23, 2004.
3. Nappi G, Maresca L, Torella M, Cotrufo M. Body perfusion in surgery of the aortic arch Tex Heart Inst J 2007;34:23-29.[Medline]
4. Della Corte A, Scardone M, Romano GP, Amarelli C, Nappi GA, Cotrufo M. Aortic arch surgery: thoracoabdominal perfusion during antegrade cerebral perfusion may reduce postoperative morbidity Ann Thorac Surg 2006;81:1358-1364.[Abstract/Free Full Text]

This article has been cited by other articles:

				A. Panos Reply. Ann. Thorac. Surg., May 1, 2009; 87(5): 1650 - 1650. [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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Gianantonio Nappi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nappi, G. Search for Related Content PubMed PubMed Citation Articles by Nappi, G. Related Collections Great vessels Related Article