The management of extracorporeal circulation in modified total arch replacement combined with stented elephant trunk
10.3760/cma.j.issn.1673-4904.2015.08.011
- VernacularTitle:改良全弓置换加支架象鼻手术的体外循环管理
- Author:
Yanhong ZENG
;
Zhiwei WANG
;
Weiwei ZAN
;
Hongbing WU
;
Min ZHANG
- Publication Type:Journal Article
- Keywords:
Circulatory arrest,deep hypothermia induced;
Extracorporeal circulation;
Aneurysm,dissecting;
Stents
- From:
Chinese Journal of Postgraduates of Medicine
2015;38(8):584-587
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical experience of extracorporeal circulation management in modified total arch replacement combined with stented elephant trunk.Methods Fifty-eight patients with Stanford A aortic dissection underwent modified total arch replacement combined with stented elephant trunk.With the modified surgical technique,the technology of extracorporeal circulation was also modified with bilateral antegrade cerebral perfusion,the management of the temperature and blood protection.Results All patients were operated successfully.The operative time was 248-485 (396 ± 67) min,extracorporeal circulation time was 175-260 (181 ± 33) min,cross clamp time was 64-104 (85 ± 12) min,stop circulation time was 22-48 (32 ± 5) min,and selective cerebral perfusion time was 26-54 (39 ± 7) min.The ventilator assisted breathing time was 5.0-35.5 (23.0 ± 4.5) h,and ICU monitoring time was 24-140 (88 ± 12) h.Postoperative complications included transient neurologic deficit in 3 cases (5.2％,3/58),renal dysfunction in 5 case (8.6％,5/58),and pulmonary infection in 4 cases (6.9％,4/58).Conclusion To modified total arch replacement combined with stented elephant trunk,the modified management of extracorporeal circulation with bilateral antegrade cerebral perfusion,the management of temperature and blood protection,has a low prevalence of morbidity and mortality.
