Aortic arch surgery principles strategies and outcomes pdf

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aortic arch surgery principles strategies and outcomes pdf

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The Spanish Association of Pediatrics has as one of its main objectives the dissemination of rigorous and updated scientific information on the different areas of pediatrics. Annals of Pediatrics is the Body of Scientific Expression of the Association and is the vehicle through which members communicate. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years.

Joseph Coselli, MD

Focusing exclusively on the surgical management of aortic arch disease in adults, this concise reference provides authoritative guidance on both standard and alternative approaches from internationally recognized experts. Topics include: general principles of aortic diseases imaging techniques intraoperative management neurologic protection strategies options for aortic repair surgical treatment of specific problems complications Abundant illustrations demonstrate significant imaging study findings and depict key techniques and strategies.

With its detailed descriptions and thorough explanations of a wide variety of approaches to imaging, brain protection and monitoring, and aortic reconstruction, Aortic Arch Surgery: Principles, Strategies and Outcomes gives practicing and prospective thoracic and cardiovascular surgeons access to the full armamentarium of management options. Anesthesiologists, perfusionists, neurologists, radiologists, and others who have a special interest in treating patients with thoracic aortic disease will also find this book an invaluable source of dependable information.

A vid R eaders. Aortic Arch Surgery. Principles, Stategies and Outcomes" Focusing exclusively on the surgical management of aortic arch disease in adults, this concise reference provides authoritative guidance on both standard and alternative approaches from internationally recognized experts.

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Aortic Arch Surgery. Principles, Stategies and Outcomes

Aortic arch repair has been shifted from deep hypothermia plus circulatory arrest to cerebral perfusion at tepid temperatures. A step forward is a simultaneous brain—coronary perfusion, allowing beating-heart arch surgery. Intracardiac repair is performed after running cardioplegia through the root line. Fifty patients are classified into 3 groups: A, Norwood 8 neonates ; B, aortic arch 14 children and C, aortic arch plus intracardiac repair 28 patients. Associated anomalies in Group C are as follows: ventricular septal defect 10 , arterial switch 5 , atrial septal defect 4 , cor triatriatum 3 , aortic commissurotomy 2 , comprehensive repair 2 , ostium primum 1 and Yasui 1.

Strategies in the surgical treatment of type A aortic arch dissection

This study aimed to evaluate the prevalence of spinal cord injury in total arch replacement with frozen elephant trunk for acute type A aortic dissection using our spinal cord protection technique. Between January and December , 33 patients underwent total arch replacement with frozen elephant trunk for acute type A aortic dissection mean age Our spinal cord protection technique involved maintaining extracorporeal circulation through the left subclavian artery in all procedures, using aortic occlusion balloon during distal anastomosis, and inserting frozen elephant trunk above Th 8 with transesophageal echocardiographic guidance. Moreover, we evaluated postoperative mortality and mobility including spinal cord injury at follow-up.

Aortic arch surgery requires complex patient management beyond the manual replacement of the diseased vessel. These procedures include i a thorough and pathologically adjusted preoperative evaluation, ii initiation and control of cardiopulmonary bypass, iii cerebral protection strategies and iv techniques to protect the abdominal end organs during prolonged operations. Due to the complexity of aortic arch procedures, multimodal real-time surveillance is required during all stages of the operation. Although having the patient survive the operation is the major goal, further observation is necessary because of the chronicity of the disease. This review summarizes specific aspects of patient management during and after operations requiring periods of circulatory arrest, without necessarily referring to all studies on this topic.

A concise reference with authoritative guidance on standard and alternative approaches from internationally recognized experts. Focusing exclusively on the surgical management of aortic arch disease in adults, this book gives practicing and prospective thoracic and cardiovascular surgeons access to the full armamentarium of management options. Anesthesiologists, perfusionists, neurologists, radiologists, and others who have a special interest in treating patients with thoracic aortic disease will also find this book an invaluable source of dependable information. It features detailed descriptions and thorough explanations of a wide variety of approaches to imaging, brain protection and monitoring, and aortic reconstruction, as well as abundant illustrations that demonstrate significant imaging study findings and depict key techniques and strategies.

Stanford type A acute aortic dissection involves the ascending aorta, aortic arch and a variable extent of the descending thoracic aorta.

INTRODUCTION

Focusing exclusively on the surgical management of aortic arch disease in adults, this concise reference provides authoritative guidance on both standard and alternative approaches from internationally recognized experts. Topics include: general principles of aortic diseases imaging techniques intraoperative management neurologic protection strategies options for aortic repair surgical treatment of specific problems complications Abundant illustrations demonstrate significant imaging study findings and depict key techniques and strategies. With its detailed descriptions and thorough explanations of a wide variety of approaches to imaging, brain protection and monitoring, and aortic reconstruction, Aortic Arch Surgery: Principles, Strategies and Outcomes gives practicing and prospective thoracic and cardiovascular surgeons access to the full armamentarium of management options. Anesthesiologists, perfusionists, neurologists, radiologists, and others who have a special interest in treating patients with thoracic aortic disease will also find this book an invaluable source of dependable information. A vid R eaders. Aortic Arch Surgery.

The surgical treatment of the aortic arch includes unique obstacles compounding the typical challenges faced by traditional cardiac surgery. Owing to the exquisite sensitivity of neurologic tissue to ischemic injury, the vital importance of safely protecting the brain during inevitable interruptions normal cerebral perfusion cannot be understated. Over the years, substantial efforts have been devoted to clinical and laboratory research in an effort to elucidate the optimal techniques for protecting the brain during aortic arch surgery. The three main types of neuroprotection - hypothermic circulatory arrest, antegrade cerebral perfusion, and retrograde cerebral perfusion - have been well documented in this issue. While our group initially believed that cerebral circulatory arrest for up to an hour at profound hypothermia was safe, prolonged patient awakening times led us to question the veracity of this belief.

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