Utility of the Isolation Technique for Total Arch Replacement in Patients with a Shaggy Aorta / 日本心臓血管外科学会雑誌

ABSTRACT

Introduction: Prevention of embolic stroke is the key issue to perform aortic arch replacement in patients with a shaggy aorta. The aim of this study is to report the utility of the isolation technique for total arch replacement in patients with a shaggy aorta. Methods: Clinical results of seven patients (71.7 years old, all men) with a shaggy aorta who underwent total arch replacement between January 2017 and November 2018 were retrospectively reviewed. The operative indications were a distal arch or proximal descending aortic aneurysm in 6 patients and a thrombus inside brachiocephalic artery in one. A cerebral perfusion was established by inserting a cannula directly into all supra-aortic branches before starting systemic perfusion. Result: Utilizing the isolation technique with clamping of all branches in 4 patients and the functional isolation technique with clamping of two branches in 3, total arch replacement was performed in all patients (operation time 513 min, selective cerebral perfusion time 162 min). No operative death was observed and no newly developed stroke was encountered. Conclusion: The isolation technique is a useful method to prevent stroke during total arch replacement in patients with a shaggy aorta.