Surgical Treatment of Aortic Arch Aneurysms in Profound Hypothermia and Circulatory Arrest Martin Grabenwöger, Marek Ehrlich, Fabiola Cartes-Zumelzu,

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Presentation transcript:

Surgical Treatment of Aortic Arch Aneurysms in Profound Hypothermia and Circulatory Arrest Martin Grabenwöger, Marek Ehrlich, Fabiola Cartes-Zumelzu, Martina Mittlböck, Günther Weigel, Günther Laufer, Ernst Wolner, Michael Havel The Annals of Thoracic Surgery Volume 64, Issue 4, Pages 1067-1071 (October 1997) DOI: 10.1016/S0003-4975(97)00733-9

Fig. 1 Hypothermic antegrade perfusion for proximal arch replacement: after the distal anastomosis is accomplished during the period of circulatory arrest, cardiopulmonary bypass can be initiated through the side graft. The Annals of Thoracic Surgery 1997 64, 1067-1071DOI: (10.1016/S0003-4975(97)00733-9)

Fig. 2 Selective hypothermic antegrade brachiocephalic perfusion for distal arch replacement. Proximal anastomosis is performed during circulatory arrest. Thereafter the prosthesis is clamped distally and perfusion of the brachiocephalic vessels can be restored. The Annals of Thoracic Surgery 1997 64, 1067-1071DOI: (10.1016/S0003-4975(97)00733-9)

Fig. 3 Thirty-day mortality as a function of age: note the significant increase in mortality rate in patients older than 60 years. Elective and urgent operations are shown for each age group. The Annals of Thoracic Surgery 1997 64, 1067-1071DOI: (10.1016/S0003-4975(97)00733-9)

Fig. 4 Thirty-day mortality as a function of circulatory arrest time. Despite an increase in mortality rate for patients with circulatory arrest times between 41 and 50 minutes, statistical analysis did not show a direct correlation. Elective and urgent operations are shown for each circulatory arrest time group. The Annals of Thoracic Surgery 1997 64, 1067-1071DOI: (10.1016/S0003-4975(97)00733-9)

Fig. 5 Prevalence of permanent neurologic (PN) deficits as a function of circulatory arrest time. The Annals of Thoracic Surgery 1997 64, 1067-1071DOI: (10.1016/S0003-4975(97)00733-9)

Fig. 6 Prevalence of permanent neurologic (PN) deficits as a function of age. The Annals of Thoracic Surgery 1997 64, 1067-1071DOI: (10.1016/S0003-4975(97)00733-9)