Document Detail


Aortic arch aneurysm complicated with coronary artery disease: still a surgical challenge?
MedLine Citation:
PMID:  12027789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent surgical strategies and outcomes for the simultaneous operation of aortic arch repair (AAR) and coronary artery bypass grafting (CABG) were reviewed. The surgical treatment of aortic arch aneurysm complicated with coronary artery arteriosclerosis has been a challenge. In spite of recent improvements in cerebral protection during AAR such as deep hypothermia and circulatory arrest with/without retrograde cerebral perfusion, or antegrade selective cerebral perfusion (SCP), additional CABG poses a considerable surgical risk resulting in extremely higher mortality rates when compared with solo AAR. To minimize the cardiac ischemic time, several techniques such as distal coronary artery anastomosis on the perfused fibrillating heart, and coronary artery perfusion through a cardioplegic line during AAR have been employed. Recently, open stent grafting instead of aortic distal anastomosis has been attempted to minimize the cardiopulmonary time and operative complexity. Our recent experience suggested off-pump coronary artery bypass and AAR with the aid of SCP decreased cardiac ischemic time and cardiopulmonary time followed by improved operative morbidity and mortality. Further less-invasive surgical modalities that enhance the adequate myocardial protection and minimize the adverse effect of cardiopulmonary bypass can improve the outcome of this demanding operation for these elderly patients with aortic arch aneurysm and coronary artery occlusive disease.
Authors:
Hitoshi Yokoyama
Related Documents :
7362709 - Scanning suprasternal echocardiography.
19589789 - Total aortic arch stenting--hemodynamical impact of carotid artery perfusion.
7544389 - Early results with a new procedure for hypoplastic left heart syndrome and aortic atresia.
10814929 - Dissecting thoracoabdominal aortic aneurysm associated with an isolated right-sided aor...
372909 - Right aortic arch with aberrant left innominate artery.
8231269 - Surgical treatment of vascular rings: the mayo clinic experience.
3024279 - Etiology of the pulmonary pathophysiology associated with inhalation injury.
470099 - Rate related block in the canine his-purkinje system after ligation of the anterior sep...
9729559 - Zero-stress states of human pulmonary arteries and veins.
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  8     ISSN:  1341-1098     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-07-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  62-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Fukushima Medical University, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aorta, Thoracic* / pathology,  surgery
Aortic Aneurysm, Thoracic / complications*,  mortality,  surgery
Coronary Artery Bypass / mortality
Coronary Artery Disease / complications*,  mortality,  surgery
Humans
Incidence
Thoracic Surgical Procedures / mortality
Treatment Outcome
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Spotlight on paroxetine in psychiatric disorders in adults.
Next Document:  Estrogen and progesterone receptors in non small cell lung cancer patients.