Proximal aortic arch cannulation for proximal ascending aortic aneurysms

Introduction: Different arterial inflow sites have been reported to date for particularly challenging cardiac operations. The ascending aorta, femoral artery, and subclavian artery are the most commonly used sites. Although its use has been reported, the aortic arch has not gained popularity in the performance of cannulation. According to a search performed in the PubMed database, aortic arch cannulation for ascending aorta replacement has not been examined in a separate study before. In the present study, we report the treatment outcomes of patients with ascending aortic aneurysms in whom the aortic arch was cannulated for arterial inflow. Material and methods: Twenty-seven patients with aneurysmal dilatation of the ascending aorta underwent ascending aorta replacement from April 2010 to March 2013. The mean age of the patients was 64 years. All operations were carried out by cannulating the aortic arch distally from the origin of the innominate artery. Results: There was no mortality or cannulation-related morbidity. In 23 patients, only the supracoronary ascending aorta was replaced, whereas in 4 patients, the button modification of the Bentall procedure was performed to replace the root and the ascending aorta. Conclusions: The technique of aortic arch cannulation distal to the origin of the innominate artery is worthy of consideration in the treatment of aneurysms limited to the ascending aorta due to its safety, simplicity, and low morbidity

Proximal aortic arch cannulation for proximal ascending aortic aneurysms.

INTRODUCTION: Different arterial inflow sites have been reported to date for particularly challenging cardiac operations. The ascending aorta, femoral artery, and subclavian artery are the most commonly used sites. Although its use has been reported, the aortic arch has not gained popularity in the performance of cannulation. According to a search performed in the PubMed database, aortic arch cannulation for ascending aorta replacement has not been examined in a separate study before. In the present study, we report the treatment outcomes of patients with ascending aortic aneurysms in whom the aortic arch was cannulated for arterial inflow. MATERIAL AND METHODS: Twenty-seven patients with aneurysmal dilatation of the ascending aorta underwent ascending aorta replacement from April 2010 to March 2013. The mean age of the patients was 64 years. All operations were carried out by cannulating the aortic arch distally from the origin of the innominate artery. RESULTS: There was no mortality or cannulation-related morbidity. In 23 patients, only the supracoronary ascending aorta was replaced, whereas in 4 patients, the button modification of the Bentall procedure was performed to replace the root and the ascending aorta. CONCLUSIONS: The technique of aortic arch cannulation distal to the origin of the innominate artery is worthy of consideration in the treatment of aneurysms limited to the ascending aorta due to its safety, simplicity, and low morbidity

occlusive disease

Background: This study aims to examine unilateral and bilateral revascularization of aortoiliac occlusive disease via paramedian incision and retroperitoneal approach.Methods: Between January 2005 and December 2012, 74 patients (67 males, 7 females; mean age 61.6 +/- 9.5 years; range 24 to 79 years) underwent surgical revascularization for aortoiliac occlusive disease via paramedian incision and retroperitoneal approach [aortofemoral bypass (n=40), iliofemoral bypass (n=14), aortoiliac bypass (n=2) and aortobifemoral bypass (18)]. Data of the patients for unilateral aortoiliac revascularization were compared with those for bilateral aortoiliac revascularization. The preoperative characteristics and perioperative data of the patients were analyzed.Results: Three patients (3.9%) died postoperatively due to myocardial infarction and pulmonary complications. No intraoperative complications occurred. Six patients required subsequent reoperation: two for acute distal embolism to the contralateral limb, two for distal anastomosis leakage, and two for local distal wound infection. These patients were successfully treated. The patients were discharged from the hospital on antiplatelet therapy. There was no significant difference in the length of intensive care unit stay, time to oral intake, preoperative and postoperative hemoglobin levels, hematocrit levels, creatinin levels, and need for transfusion between the unilateral and bilateral revascularization patients.Conclusion: Based on our experience, the retroperitoneal aortoiliac approach with a paramedian incision has few complications and reasonable outcomes