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Right axillary arterial perfusion for descending thoracic or thoracoabdominal aortic aneurysm repair with open proximal anastomosis through left thoracotomy.
- Source :
-
General thoracic and cardiovascular surgery [Gen Thorac Cardiovasc Surg] 2014 Sep; Vol. 62 (9), pp. 547-52. Date of Electronic Publication: 2014 May 04. - Publication Year :
- 2014
-
Abstract
- Background: We examined the effectiveness of right axillary arterial perfusion through an interposed Dacron graft in the prevention of cerebral embolism or complications related to ascending aortic cannulation in open proximal anastomosis technique of descending thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA) repair under deep hypothermic circulatory arrest through left thoracotomy.<br />Methods: Between May 2000 and August 2012, 44 patients underwent TAA or TAAA repair using open proximal technique under DHCA. These patients were divided into two groups for evaluation of the effectiveness of right axillary arterial perfusion. Group A included patients who underwent TAA or TAAA repair with ascending aortic cannulation (n=15). Group B was composed of patients who had TAA or TAAA repair with right axillary arterial perfusion through the interposed Dacron graft (n=29).<br />Results: Mortality in this series was 4.5% (2 of 44 patients; 1 in each group); wherein, the causes were sepsis due to graft infection and aortic dissection (Stanford type A). The incidence rates of cerebral embolism were 27 % (4 of 15 patients in group A) and 3.4% (1 of 29 patients in group B) (p=0.0392, Fisher's exact test). The rates of complications in relation to the aortic cannulation site (dissection or bleeding) were 13% (2 of 15 patients in group A) and 0% (0 of 25 patients in group B).<br />Conclusions: Right axillary perfusion facilitates easy evacuation of air and allows prompt recommencement of upper body circulation. Consequently, it minimizes the risk of cerebral embolism or complications in relation to aortic cannulation through left thoracotomy.
- Subjects :
- Adult
Aged
Anastomosis, Surgical methods
Aortic Dissection surgery
Aorta surgery
Aortic Aneurysm, Thoracic mortality
Catheterization
Circulatory Arrest, Deep Hypothermia Induced
Female
Hospital Mortality
Humans
Male
Middle Aged
Perfusion adverse effects
Postoperative Complications epidemiology
Thoracotomy methods
Young Adult
Aortic Aneurysm, Thoracic surgery
Axilla blood supply
Blood Vessel Prosthesis Implantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1863-6713
- Volume :
- 62
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- General thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 24791925
- Full Text :
- https://doi.org/10.1007/s11748-014-0404-z