초록접수 현황
| 19F-055 | 포스터 발표 |
Ascending Aorta and Hemiarch Replacement without Hypothermic Circulatory Arrest
Dong Jin Kim
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Republic of Korea
Purpose : Clamping in the ascending aorta has limitations to replace the distal ascending aorta and proximal arch. Using deep hypothermic circulatory arrest is the conventional approach for proximal aortic arch reconstruction. We report a surgical technique for hemiarch replacement that can be performed without circulatory arrest
Methods : For cardiopulmonary bypass(CPB), the arterial cannulation was performed in the distal arch. Innominate artery(IA) and proximal arch was dissected circumferentially. During hemiarch replacement aortic cross clamp(ACC) was performed between IA and left common carotid artery. IA was perfused selectively during anastomosis without hypothermic circulatory arrest.
Results : Three patients underwent hemiarch replacement without hypothermic arrest with this method. There were no mortality nor neurologic complication. CT angiography was performed post operatively in all patients. The anastomotic boundary of the lesser curvature was able to be covered at least up to zone 1(classifications established by Mitchell and Ishimura, J Endovasc Ther 2002;9 Suppl 2:II98-105) and it was confirmed after the imaging study.
Conclusion : Although current strategy of hypothermic circulatory arrest is relatively safe, it certainly carries some risk of stroke, renal failure and coagulopathy. In patients who is predicted to have hazardous results with circulatory arrest(old age, history of stroke/kidney disease/liver disease/ coagulopathy etc) or who needs only short segment of proximal arch replacement, this surgical strategy certainly can take advantages
Methods : For cardiopulmonary bypass(CPB), the arterial cannulation was performed in the distal arch. Innominate artery(IA) and proximal arch was dissected circumferentially. During hemiarch replacement aortic cross clamp(ACC) was performed between IA and left common carotid artery. IA was perfused selectively during anastomosis without hypothermic circulatory arrest.
Results : Three patients underwent hemiarch replacement without hypothermic arrest with this method. There were no mortality nor neurologic complication. CT angiography was performed post operatively in all patients. The anastomotic boundary of the lesser curvature was able to be covered at least up to zone 1(classifications established by Mitchell and Ishimura, J Endovasc Ther 2002;9 Suppl 2:II98-105) and it was confirmed after the imaging study.
Conclusion : Although current strategy of hypothermic circulatory arrest is relatively safe, it certainly carries some risk of stroke, renal failure and coagulopathy. In patients who is predicted to have hazardous results with circulatory arrest(old age, history of stroke/kidney disease/liver disease/ coagulopathy etc) or who needs only short segment of proximal arch replacement, this surgical strategy certainly can take advantages
책임저자: Dong Jin Kim
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Republic of Korea
발표자: Dong Jin Kim, E-mail : shallbe@hanmail.net