Sage Journals: Discover world-class research

Abstract

Surgery for aneurysms of the aorta is a formidable challenge especially when these aneurysms involve the ascending aorta and the transverse arch. We have used the technique of cardiopulmonary bypass, profound hypothermia and total circulatory arrest with marked reduction in neurological complications. Availability of albumin coated and gelatin sealed grafts, as well as blood components, has reduced the associated bleeding problems. Ninety-six patients with aneurysms of the ascending aorta and the transverse arch were operated upon between 1983 and 1993. Patients with aneurysms of the sinus of Valsalva have not been included in this study. Syphilitic pathology was predominant in the group with late presentation of very large aneurysms. The mortality was 17.71% and was largely due to low cardiac output, prolonged ventilatory support, lung infections, and mediastinitis.

Get full access to this article

View all access options for this article.

References

DeBakey

Crawford

Cooley

Morris

Successful resection of fusiform aneurysm of aortic arch with replacement by homograft. Surg Gynecol Obstet 1957;105:657–64.

Miller

Stinson

Oyer

Concomitant resection of ascending aortic aneurysm and replacement of the aortic valve with ‘conventional’ techniques in ninety patients. J Thorac Cardiovasc Surg 1980;79:388–401.

Wheat

Jr Wilson

Bartley

. Successful replacement of the entire ascending aorta and aortic valve. JAMA 1964;188:717–9.

Griepp

Stinson

Hollingworth

Buchler

. Prosthetic replacement of the aortic arch. J Thorac Cardiovasc Surg 1975;70:1051–63.

Bentall

Debono

A technique for complete replacement of the ascending aorta. Thorax 1968;23:338–9.

Cabrol

Pravie

Mesnildrey

Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries. J Thorac Cardiovasc Surg 1986;91:17–25.

Cooley

Romagnoli

Milani

Bossart

A method of preparing woven dacron aortic grafts to prevent interstitial hemorrhage. Cardiovasc Dis Bull Tex Heart Inst 1981;8:48–52.

Lewis

CTP

Cooley

Murphy

Talledo

Vega

Surgical repair of aortic root aneurysms in 280 patients. Ann Thorac Surg 1992;53:38–46.

Crawford

Swensson

Coselli

Safi

Hess

Surgical treatment of aneurysms and/or dissection of ascending aorta, transverse aortic arch. Factors influencing survival in 717 patients. J Thorac Cardiovasc Surg 1989;98:659–74.

10.

Okamoto

Sato

Matsuura

Selective jugular cannulation for safer retrograde cerebral perfusion. Ann Thorac Surg 1993;55:538–40.

11.

Ueda

Miki

Kusuhara

Okida

Tahata

Surgical treatment of aneurysms or dissection involving the ascending aorta and aortic arch utilising circulatory arrest and retrograde cerebral perfusion. J Thorac Cardiovasc Surg 1990;31:553–8.

12.

Bachet

Guilmet

Goudot

Cold cerebroplegia: A new technique of cerebral protection during operations on the transverse aortic arch. J Thorac Cardiovasc Surg 1991;102:85–94.

13.

Yasuura

Ogawa

Okamoto

Successful resection of a distal aortic arch aneurysm and hypothermic total body retrograde perfusion. Thorac Cardiovasc Surg 1992;40:219–22.

14.

Yasuura

Ogawa

Okamoto

Clinical application of total body retrograde perfusion in aortic dissection. Ann Thorac Surg 1992;53:655–8.

Surgical Treatment of Aneurysms of the Ascending Aorta and Aortic Arch

Abstract

Get full access to this article

References