Document Detail

Tactics and techniques of aortic arch replacement.
MedLine Citation:
PMID:  7994096     Owner:  NLM     Status:  MEDLINE    
Operations on the nondissected and dissected aortic arch still pose challenges in terms of the need for and extent of aortic replacement. Our approaches to these lesions are described against the background of 204 operations (58 aneurysms, 54 chronic dissections, and 92 acute dissections), in terms of cerebral protection, procedural choices, and operative technique. Arch anastomoses sparing the supraaortic vessels had shorter periods of circulatory arrest (17.2 min) when compared to tubular arch replacement, with insertion of some or all of these vessels (33.7 min). Early death rates due to cerebral complications were lowest in acute dissections (3/14 fatalities, with two patients showing preoperative cerebral compromise). Based on our experience, we recommend doing subtotal or total arch replacement in aneurysms regardless of cause. Radical arch surgery should be avoided in acute dissections whenever feasible. Instead, the arch should be explored and a blood-tight distal anastomosis made, going beyond any entry tears encountered in that aortic portion.
H G Borst; B Bühner; M Jurmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  9     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1995-01-18     Completed Date:  1995-01-18     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:  538-47     Citation Subset:  IM    
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.
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MeSH Terms
Acute Disease
Aneurysm, Dissecting / surgery*
Aorta, Thoracic / surgery*
Aortic Aneurysm, Thoracic / surgery*
Blood Vessel Prosthesis / methods*,  mortality
Chronic Disease
Heart Arrest, Induced
Middle Aged
Vascular Surgical Procedures / methods,  mortality

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