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Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair  Hazim J Safi, MD, Anders Winnerkvist, MD, Charles C Miller, PhD, Dimitrios.

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Presentation on theme: "Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair  Hazim J Safi, MD, Anders Winnerkvist, MD, Charles C Miller, PhD, Dimitrios."— Presentation transcript:

1 Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair 
Hazim J Safi, MD, Anders Winnerkvist, MD, Charles C Miller, PhD, Dimitrios C Iliopoulos, MD, Michael J Reardon, MD, Rafael Espada, MD, John C Baldwin, MD  The Annals of Thoracic Surgery  Volume 66, Issue 4, Pages (October 1998) DOI: /S (98)

2 Fig 1 Thoracoabdominal aortic aneurysm classification. Type I: below the left subclavian to above the celiac axis or opposite the superior mesenteric and above the renal arteries. Type II: below the left subclavian and including the infrarenal abdominal aorta to the level of the aortic bifurcation. Type III: the sixth intercostal space, tapering to just above the infrarenal abdominal aorta to the iliac bifurcation. Type IV: the twelfth intercostal space, tapering to above the iliac bifurcation. Type V: the sixth intercostal space, tapering to just above the renal arteries. The Annals of Thoracic Surgery  , DOI: ( /S (98) )

3 Fig 2 Illustrations of type II thoracoabdominal aortic aneurysm repair with adjuncts. (A) Computed tomographic scan and aortogram of type II thoracoabdominal aortic aneurysm. (B) Left atrial to femoral bypass with the BioMedicus pump for distal aortic perfusion. Cerebrospinal fluid drainage also was used. (C) Despite aneurysm extent and clamp time greater than 60 minutes, adjuncts permitted ample time for intercostal artery reattachment with graft replacement. The Annals of Thoracic Surgery  , DOI: ( /S (98) )

4 Fig 2 Illustrations of type II thoracoabdominal aortic aneurysm repair with adjuncts. (A) Computed tomographic scan and aortogram of type II thoracoabdominal aortic aneurysm. (B) Left atrial to femoral bypass with the BioMedicus pump for distal aortic perfusion. Cerebrospinal fluid drainage also was used. (C) Despite aneurysm extent and clamp time greater than 60 minutes, adjuncts permitted ample time for intercostal artery reattachment with graft replacement. The Annals of Thoracic Surgery  , DOI: ( /S (98) )

5 Fig 3 Relationship between cross-clamp and adjunct, type II thoracoabdominal aortic aneurysm (TAAA). (A = current study, patients without adjuncts; B = Crawford experience, cross-clamp and go [5]; C = current study, patients with adjuncts.) The Annals of Thoracic Surgery  , DOI: ( /S (98) )

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