AW: [HSF] Descending Aorta aneurysmectomy after operated Type A Dissection- Perfusion through the ventricle.

[Edward Bender]

Roberto:
At the first operation were any head vessels reimplanted?
Ed Bender, MD


On Aug 3, 2007, at 10:22 AM, Dr. Roberto Battellini wrote:

>
> For aortic surgery lovers:
> I want to comment a case we did 2 days ago with our master and  
> friend, Fred
> Mohr.
> The patient, born in 1937, got 2 years ago an ascending and partial  
> arch
> resection for Type A dissection. The distal aorta remained  
> dissected and
> grew up to 6 cm. The aorta was very wide until the diaphragm.
>
> Elective operation:  Left lateral thoracotomy cutting the  
> condrocostal union
> and diaphragm in circular art.(I prepare all this cases)
> The left femoral artery and vein were first cannulated, with a Y  
> connector.
> First, perfusion at 32 degrees centigrades. Vent in the ventricle  
> apex.
> Distal Aortic clamping at the diaphragm level, and anastomosis with  
> a 24
> Dacron Haemashield, on the beating heart just over the truncus  
> coeliacus.
>
> Then,clamping the distal prosthesis, continuing the perfusion to 24  
> degrees,
> and perfusing proximally (antegradelly) through the left ventricle  
> apex.
> At 24 degrees, stop the proximal perfusion, and resection of the  
> distal
> arch, leaving the origin of the great vessels. Proximal anastomosis  
> under
> DHCA, 16 minutes. Continuing after the perfusion through the  
> ventricle, this
> is very interesting because it allows to deair!!! Then, clamping the
> proximal prosthesis, for later anastomosis with the distal one.
> In the thoracic aorta 2 pairs of intercostal arteries were  
> reimplanted.
>
> Patient awake, neurologically ok, she was 2 days at ICU.
>
> We have done several of this cases, now are doing this ventricular
> perfusion, very nice for deairing.
>
> Roberto
>
> _______________________________________________
> OpenHeart-L mailing list
>
> Send postings to:
>  OpenHeart-L at lists.hsforum.com
>
> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> http://mmp.cjp.com/mailman/listinfo/openheart-l
>
> All messages transmitted by the OpenHeart-L are subject to the  
> policies and
> disclaimers posted at:
> http://www.hsforum.com/listdisclaim
> -----------------------------------------