The early and midterm results of total aortic arch replacement for aortic aneurysm without cardiopulmonary bypass
10.3760/cma.j.issn.1001-4497.2011.06.007
- VernacularTitle:非体外循环下全主动脉弓替换术治疗主动脉弓降部动脉瘤的早、中期结果
- Author:
Lizhong SUN
;
Junming ZHU
;
Zhigang LIU
;
Liangxin TIAN
- Publication Type:Journal Article
- Keywords:
Aortic aneurysm;
Blood vessel prosthesis implantation;
Aorta,thoracic
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2011;27(6):339-341
- CountryChina
- Language:Chinese
-
Abstract:
Objective Study the early and midterm results of a technique-total aortic arch replacement without using extracorporeal circulation or aortic bypass for the treatment of aortic aneurismal disease involving the transverse aortic arch and proximal descending aorta. Methods Between April and November 2004, 7 consecutive patients with true (n = 3) or false (n =4) aortic aneurysm underwent this procedure. The mean follow-up was 6. 6 years. The median age at operation was 57years ( range 23 to 75 years). Normothermia general anesthesia and median sternotomy combined with left anterior thoracotomy were administered. A partially occluding clamp was placed on ascending aorta and a longitude aortic incision was made. Anastomosis of a branched graft to ascending aorta in an end-to-side fashion was commenced. The descending aorta distal to the aneurysm was occluded and transected, and anastomosed to the distal end of the branched graft in an end-to-end fashion. Finally,the arch vessels were divided and anastomosed to the branches of the graft and the aneurysm excised. Results The average cross-clamp time of descending aorta, left common carotid artery, and innominate artery was (13.6 ±5.6)min, (5.7 ±0.8)min, and (7.8±2.5) min respectively. The mean intubation time was (12.3 ±4.1) hours. There were no adverse outcomes or neurologic complications in this series. All patients survived and recovered completely. The mean follow-up time was (79.7 ±2.1) months. All patients lead a normal life. There was no late death. CT follow-up study 6 years after surgery reveals no abnormal image. Conclusion Total aortic arch replacement without cardiopulmonary and aortic bypass is a feasible and effective method for the aortic aneurismal disease involving the transverse aortic arch and proximal descending aorta in selected patients.
