Utility of the Isolation Technique for Total Arch Replacement in Patients with a Shaggy Aorta
- VernacularTitle:著明な粥状硬化を伴った弓部大動脈瘤に対する isolation 法を用いた弓部全置換術
- Author:
Takumi KAWASE
1
;
Kyokun UEHARA
1
;
Yosuke INOUE
1
;
Atsushi OMURA
1
;
Yoshimasa SEIKE
1
;
Hiroaki SASAKI
1
;
Hitoshi MATSUDA
1
;
Junjiro KOBAYASHI
1
Author Information
- Keywords: isolation technique; aortic arch replacement; shaggy aorta
- From:Japanese Journal of Cardiovascular Surgery 2020;49(3):93-98
- CountryJapan
- Language:Japanese
- Abstract: Introduction : Prevention of embolic stroke is the key issue to perform aortic arch replacement in patients with a shaggy aorta. The aim of this study is to report the utility of the isolation technique for total arch replacement in patients with a shaggy aorta. Methods : Clinical results of seven patients (71.7 years old, all men) with a shaggy aorta who underwent total arch replacement between January 2017 and November 2018 were retrospectively reviewed. The operative indications were a distal arch or proximal descending aortic aneurysm in 6 patients and a thrombus inside brachiocephalic artery in one. A cerebral perfusion was established by inserting a cannula directly into all supra-aortic branches before starting systemic perfusion. Result : Utilizing the isolation technique with clamping of all branches in 4 patients and the functional isolation technique with clamping of two branches in 3, total arch replacement was performed in all patients (operation time : 513 min, selective cerebral perfusion time : 162 min). No operative death was observed and no newly developed stroke was encountered. Conclusion : The isolation technique is a useful method to prevent stroke during total arch replacement in patients with a shaggy aorta.
