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Total arch replacement using a 4‐branched vascular graft without circulatory arrest
Author(s) -
Long Chaozhong,
Feng Yaoguang,
He Dapu,
Wang Yuanxing,
Lyv Xiaolin,
Kuang Wenan
Publication year - 2019
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14043
Subject(s) - medicine , descending aorta , femoral artery , anastomosis , perfusion , balloon , circulatory system , aorta , lumen (anatomy) , cerebral perfusion pressure , ischemia , aortic arch , cardiology , surgery
The technical essentials of the procedure include femoral artery cannulation, selective antegrade cerebral perfusion for brain protection, total arch replacement with a 4‐branched vascular graft, implantation of the special open stented graft into the descending aorta, moderate hypothermic balloon occluding descending aorta at 25℃. This technique allows arch reconstruction to be debranched first and upper part of the body is perfused via the 4‐branched vascular graft, ensuring antegrade true lumen cerebral perfusion rapidly secured, the descending aorta is arrested by balloon occluding and early rewarming and reperfusion after distal anastomosis to minimize organs ischemia.