| Aortic arch aneurysm complicated with coronary artery disease: still a surgical challenge? | |
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MedLine Citation:
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PMID: 12027789 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Hitoshi Yokoyama |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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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:
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Created Date: 2002-05-24 Completed Date: 2002-07-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9703158 Medline TA: Ann Thorac Cardiovasc Surg Country: Japan |
Other Details:
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Languages: eng Pagination: 62-8 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Fukushima Medical University, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aorta, Thoracic*
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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
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