Document Detail

Anterolateral thoracotomy for distal aortic arch disease.
MedLine Citation:
PMID:  16249846     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Optimal exposure and antegrade arterial perfusion are keys to avoiding complications in the repair of distal aortic arch disease. To achieve these ends, we performed distal aortic arch repair through a left anterolateral thoracotomy while also using axillary artery perfusion. METHODS: From Mach 1998 to December 2004, 28 patients (23 men and 5 women, age 65.2 +/- 12.0 years) underwent a distal aortic arch repair through a left anterolateral thoracotomy. All cases had atherosclerotic aneurysms. Emergency surgery was performed in 1 of these cases (1/28, 3.6%) with an aortic rupture. The right axillary artery was used for arterial perfusion in all cases. RESULTS: No perfusion problems occurred during surgery, and the left anterolateral thoracotomy approach provided an excellent view of both the aortic arch and descending aorta. There was no hospital mortality. Morbidity included one incident of transient convulsion without computed tomographic evidence of an embolism and one incident of heart failure that required temporary mechanical support. No other significant event or morbidity occurred related to the surgical methods. There was no late death during the 1 to 81-month follow-up. CONCLUSION: A left anterolateral thoractomy provides an ideal view of distal aortic arch disease, and antegrade arterial perfusion is effective in the prevention of retrograde embolism. These results suggest this treatment modality to be a reliable alternative approach for the repair of distal aortic arch disease.
Koji Kawahito; Hideo Adachi; Takashi Ino
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery today     Volume:  35     ISSN:  0941-1291     ISO Abbreviation:  Surg. Today     Publication Date:  2005  
Date Detail:
Created Date:  2005-10-26     Completed Date:  2006-02-14     Revised Date:  2006-08-03    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  929-34     Citation Subset:  IM    
Department of Cardiovascular Surgery, Omiya Medical Center, Jichi Medical School, Saitama, Japan.
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MeSH Terms
Aorta, Thoracic / surgery
Aortic Aneurysm, Thoracic / surgery*
Axillary Artery
Cardiopulmonary Bypass / methods
Cardiovascular Surgical Procedures / methods
Postoperative Hemorrhage
Thoracotomy / methods*

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