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

[Tohru Asai]

Roberto

Thanks for sharing an interesting case. And congulaturate on your success in
such demanding surgery. A ventricular perfusion is a novel approach,
especially for cases with previous sternotomy. I knew the subclavian
arteries and the ascending aorta ( with sternal transsection )as central
cannulation as options ( but I never used them.)

I used to do these cases with simple DHCA with femoral artery cannulation
only. And mostly I replace upper half of descending aorta ( usually a curved
distal arch is the largest in size) via 4th or 5th left thoracotomy. But in
your case, probably whole descending aorta was enlarged, then we need to do
as you did.

Regarding deairring, I think that tilting head down and controlling CVP over
12-15 are good enough for distal arch anastomosis construction.

Robert, BTW do you employ apical cannulation for acute type A opeation as
well? And what kind of vent in apex do you use? Describe product name
please.
-- 
Tohru Asai