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

[erdinç naseri]

Dear Robertto,
1.How  do you prfuse proximally through LV apex and also deair the same awy?what cannulae?
2.do you consider 24 degree deep hypothermia ( if I haven't got wrong) ?the period of safe arrest at 24 degree must be around 15 minutes.
3.Do you use any technique for spinal cord protection in these operations.
erdinc> From: ebender001 at charter.net> Subject: Re: AW: [HSF] Descending Aorta aneurysmectomy after operated Type A Dissection- Perfusion through the ventricle.> Date: Fri, 3 Aug 2007 17:17:18 -0500> To: OpenHeart-L at lists.hsforum.com> CC: > > 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> > -----------------------------------------> > _______________________________________________> 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> -----------------------------------------