Selective cerebral perfusion with 4-branch graft total aortic arch replacement: Outcomes in 12 patients

Wei Liang Lai, Chiao Po Hsu, Chung Che Shih, Ming Li Li, Ping chun Li

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Aortic arch reconstruction is associated with high neurological morbidity. Our purpose is to describe our experience using a 4-branched graft and selective antegrade brain perfusion (SABP) for total aortic arch replacement (TAR).Methods: We retrospectively reviewed the medical records of 12 patients who received TAR, with or without ascending aorta replacement, with a 4-branched graft for Stanford type A dissection (n = 9) or aortic arch aneurysm (n = 3). In all patients surgery was performed with deep hypothermic circulatory arrest (DHCA) with or without retrograde brain perfusion, and selective antegrade brain perfusion (SABP) via the subclavian artery or axillary artery.Results: There were 8 males and 4 females with an average age of 63.14 years. Emergent operations were performed in 9 patients with acute type A aortic dissections. Of all 12 patients, 2 deaths occurred and 1 patient experienced lower extremity paraplegia resulting in an in-hospital mortality rate of 16.6% and a permanent neurological deficit rate of 8.3%.Conclusions: The use of a 4-branched graft, hypothermic circulatory arrest, and SABP is a useful operative method for aortic arch replacement with acceptable morbidity and mortality.

Original languageEnglish
Article number32
JournalJournal of Cardiothoracic Surgery
Volume7
Issue number1
DOIs
Publication statusPublished - Apr 13 2012
Externally publishedYes

Fingerprint

Thoracic Aorta
Perfusion
Transplants
Brain
Dissection
Deep Hypothermia Induced Circulatory Arrest
Axillary Artery
Morbidity
Subclavian Artery
Mortality
Aortic Aneurysm
Paraplegia
Hospital Mortality
Medical Records
Aorta
Lower Extremity

Keywords

  • Aortic arch aneurysm
  • Branched aortic graft
  • Type A aortic dissection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Selective cerebral perfusion with 4-branch graft total aortic arch replacement : Outcomes in 12 patients. / Lai, Wei Liang; Hsu, Chiao Po; Shih, Chung Che; Li, Ming Li; Li, Ping chun.

In: Journal of Cardiothoracic Surgery, Vol. 7, No. 1, 32, 13.04.2012.

Research output: Contribution to journalArticle

@article{f04d75583d164e3eb37948dc60641a82,
title = "Selective cerebral perfusion with 4-branch graft total aortic arch replacement: Outcomes in 12 patients",
abstract = "Background: Aortic arch reconstruction is associated with high neurological morbidity. Our purpose is to describe our experience using a 4-branched graft and selective antegrade brain perfusion (SABP) for total aortic arch replacement (TAR).Methods: We retrospectively reviewed the medical records of 12 patients who received TAR, with or without ascending aorta replacement, with a 4-branched graft for Stanford type A dissection (n = 9) or aortic arch aneurysm (n = 3). In all patients surgery was performed with deep hypothermic circulatory arrest (DHCA) with or without retrograde brain perfusion, and selective antegrade brain perfusion (SABP) via the subclavian artery or axillary artery.Results: There were 8 males and 4 females with an average age of 63.14 years. Emergent operations were performed in 9 patients with acute type A aortic dissections. Of all 12 patients, 2 deaths occurred and 1 patient experienced lower extremity paraplegia resulting in an in-hospital mortality rate of 16.6{\%} and a permanent neurological deficit rate of 8.3{\%}.Conclusions: The use of a 4-branched graft, hypothermic circulatory arrest, and SABP is a useful operative method for aortic arch replacement with acceptable morbidity and mortality.",
keywords = "Aortic arch aneurysm, Branched aortic graft, Type A aortic dissection",
author = "Lai, {Wei Liang} and Hsu, {Chiao Po} and Shih, {Chung Che} and Li, {Ming Li} and Li, {Ping chun}",
year = "2012",
month = "4",
day = "13",
doi = "10.1186/1749-8090-7-32",
language = "English",
volume = "7",
journal = "Journal of Cardiothoracic Surgery",
issn = "1749-8090",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Selective cerebral perfusion with 4-branch graft total aortic arch replacement

T2 - Outcomes in 12 patients

AU - Lai, Wei Liang

AU - Hsu, Chiao Po

AU - Shih, Chung Che

AU - Li, Ming Li

AU - Li, Ping chun

PY - 2012/4/13

Y1 - 2012/4/13

N2 - Background: Aortic arch reconstruction is associated with high neurological morbidity. Our purpose is to describe our experience using a 4-branched graft and selective antegrade brain perfusion (SABP) for total aortic arch replacement (TAR).Methods: We retrospectively reviewed the medical records of 12 patients who received TAR, with or without ascending aorta replacement, with a 4-branched graft for Stanford type A dissection (n = 9) or aortic arch aneurysm (n = 3). In all patients surgery was performed with deep hypothermic circulatory arrest (DHCA) with or without retrograde brain perfusion, and selective antegrade brain perfusion (SABP) via the subclavian artery or axillary artery.Results: There were 8 males and 4 females with an average age of 63.14 years. Emergent operations were performed in 9 patients with acute type A aortic dissections. Of all 12 patients, 2 deaths occurred and 1 patient experienced lower extremity paraplegia resulting in an in-hospital mortality rate of 16.6% and a permanent neurological deficit rate of 8.3%.Conclusions: The use of a 4-branched graft, hypothermic circulatory arrest, and SABP is a useful operative method for aortic arch replacement with acceptable morbidity and mortality.

AB - Background: Aortic arch reconstruction is associated with high neurological morbidity. Our purpose is to describe our experience using a 4-branched graft and selective antegrade brain perfusion (SABP) for total aortic arch replacement (TAR).Methods: We retrospectively reviewed the medical records of 12 patients who received TAR, with or without ascending aorta replacement, with a 4-branched graft for Stanford type A dissection (n = 9) or aortic arch aneurysm (n = 3). In all patients surgery was performed with deep hypothermic circulatory arrest (DHCA) with or without retrograde brain perfusion, and selective antegrade brain perfusion (SABP) via the subclavian artery or axillary artery.Results: There were 8 males and 4 females with an average age of 63.14 years. Emergent operations were performed in 9 patients with acute type A aortic dissections. Of all 12 patients, 2 deaths occurred and 1 patient experienced lower extremity paraplegia resulting in an in-hospital mortality rate of 16.6% and a permanent neurological deficit rate of 8.3%.Conclusions: The use of a 4-branched graft, hypothermic circulatory arrest, and SABP is a useful operative method for aortic arch replacement with acceptable morbidity and mortality.

KW - Aortic arch aneurysm

KW - Branched aortic graft

KW - Type A aortic dissection

UR - http://www.scopus.com/inward/record.url?scp=84859635582&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859635582&partnerID=8YFLogxK

U2 - 10.1186/1749-8090-7-32

DO - 10.1186/1749-8090-7-32

M3 - Article

C2 - 22502631

AN - SCOPUS:84859635582

VL - 7

JO - Journal of Cardiothoracic Surgery

JF - Journal of Cardiothoracic Surgery

SN - 1749-8090

IS - 1

M1 - 32

ER -