8Spurious Aneurysm at the Origin of RCA After Graft Inclusion Technique in Composite Graft
9Spurious Aneurysm of the Aortic Root After Composite Graft: Detachment of the Coronary Orifice
10COMPOSITE GRAFT IN MARFAN’S DISEASE: False aneurysm at the origin of LMCA LA35 year old male with Marfan, 9 y. after composite graft repair for acute Type A dissectionFalse aneurysmTrue lumenBS 25Aortic valveBS 25RVOTComposite graft (compressed)Courtesy Prof.Jenni, Echocardiography USZ
11FALSE ANEURYSM AT THE ORIGIN OF LMCA AFTER COMPOSITE GRAFT LALeakage into the false aneurysmTrue lumenBS 25Aortic valveComposite graftRVOT
14Myocardial Protection in Ascending Aortic Surgery Zurich 2003 Systemic hypothermia 280CBegin with retrograde cardioplegia, cross-clamp and arrest with antegrade perfusion directly into coronaries (except in acute Type A).Continuos retrograde cold oxygenated 160C throughout procedure.Warm reperfusion (“hot shot”)
25Hemiarch Bentall Procedure Subclavian/Innominate Artery Perfusion Technique Monitor left and right radial, and femoral artery pressure.Cannulation of subclavian/innominate artery.Cool patient to 280 C.Cross clamp innominate and left carotid, block left subclavian artery with balloon, perfuse upper body with 10 ml/kg, and administer antegrade and retrograde CPL.Perform distal anastomosis first, clamp the graft and resume body perfusion.Perfrom proximal part of the operation (valve and coronaries).Re-anastomose proximal and distal graft segment.