Replacement of extended aortic arch aneurysm using partial sternotomy under beating heart and continuous cardiac perfusion

Abstract

We report the case of a 72-year-old male patient who presented with a progressive aortic arch aneurysm. To reduce surgical trauma, we planned the procedure using an upper partial sternotomy with continuous cardiac perfusion and moderate hypothermia. Two vents were inserted to provide sufficient relief to the heart during perfusion. The heart was perfused continuously under flow and pressure control. To treat the aneurysm, a Vascutec™ Thoraflex Hybrid prosthesis was implanted. Despite the minimally invasive approach of partial sternotomy and beating heart combined with moderate hypothermia, the procedure was performed safely, quickly and without complications. The operation required precise pre-planning of the anatomy, outstanding surgical expertise and excellent interdisciplinary cooperation with the anaesthetist and clinical perfusionist.