Document Detail


Aortic valve replacement under deep hypothermic circulatory arrest.
MedLine Citation:
PMID:  12489904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aortic valve replacement (AVR) in the presence of a calcified aorta or patent grafts may preclude clamping of the ascending aorta. We employed deep hypothermic circulatory arrest in order to circumvent this problem. METHODS: Between January 1993 and December 2000, 415 patients underwent AVR in our department. Eight of these were operated using deep hypothermic circulatory arrest. There were 5 males, and mean age was 72 years (range 56-81). Indications for using circulatory arrest were reoperation with patent grafts and/or severe calcification of the ascending aorta. In six patients, cardiopulmonary bypass was achieved via femoro-femoral bypass, and in two via aortic-right atrial cannulation. Retrograde cerebral perfusion was employed in five. Mean bypass time was 155 minutes (range 122-187), and mean circulatory arrest time was 38 minutes (range 31-49). RESULTS: There was no operative mortality, and no patient suffered any neurologic sequelae. Echocardiography showed all valves to be functioning well. CONCLUSIONS: AVR under deep hypothermic circulatory arrest can be accomplished with an acceptable degree of safety. It should be considered as an alternative in patients in whom aortic clamping is prohibitive, and might otherwise be considered inoperable. The ability to connect the patient to bypass and the presence of a "window" to allow aortotomy are prerequisites for employing this method.
Authors:
Shuli Silberman; Nadiv Shapira; Daniel Fink; Ofer Merin; Maher Deeb; Dani Bitran
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  17     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2002 May-Jun
Date Detail:
Created Date:  2002-12-19     Completed Date:  2003-04-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  205-8     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, Jerusalem, Israel. cts-szmc@szmc.org.il
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve / pathology*,  surgery*,  ultrasonography
Aortic Valve Insufficiency / mortality,  surgery
Aortic Valve Stenosis / mortality,  surgery
Calcinosis / mortality,  surgery
Cardiopulmonary Bypass
Echocardiography
Female
Follow-Up Studies
Heart Arrest, Induced*
Heart Valve Prosthesis*
Humans
Hypothermia, Induced*
Israel
Length of Stay
Male
Middle Aged
Survival Analysis
Treatment Outcome

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


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