Authors: Nobuyoshi Kawaharada Toshiro Ito Shuichi Naraoka Takayuki Hagiwara Tetsuya Koyanagi Yoshihiko Kurimoto Tetsuya Higami
Publish Date: 2014/05/04
Volume: 62, Issue: 9, Pages: 547-552
Abstract
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 thoracotomyBetween 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 = 29Mortality in this series was 45 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 34 1 of 29 patients in group B p = 00392 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 BRight 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
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