Arch-first technique via clamshell incision - Successful surgical reoperation for aortic arch dissection
TEXAS HEART INSTITUTE JOURNAL, vol.32, no.2, pp.151-153, 2005 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 32 Issue: 2
- Publication Date: 2005
- Journal Name: TEXAS HEART INSTITUTE JOURNAL
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.151-153
- Istanbul University Affiliated: No
Abstract
We report a case of successful reoperation for aortic arch dissection with use of the "arch-first" technique in a patient who had Marfan syndrome. Extracorporeal circulation was initiated via right subclavian artery cannulation, and the chest was entered through a clamshell incision for the best exposure. When the patient was cooled to 18 degrees C, the perfusion was stopped. After the 1st aortic arch anastomosis to a 30-mm Dacron graft, cerebral perfusion was reestablished via the right subclavian artery. The aortic repair was then completed. The cerebral ischemic time was 18 minutes, the aortic cross-clamp time was 69 minutes, and the total extracorporeal circulation time was 334 minutes. The patient was discharged from the hospital on postoperative day 10 with no neurologic impairment. T