Left Thoracotomy, Deep Hypothermia and Total Body Retrograde Perfusion for Descending Thoracic Aortic Disease―A Ten-Year Experience

(Division of Cardiovascular Surgery, Okazaki City Hospital, Okazaki, Japan)

Kazutaka Horiuchi Kenzo Yasuura Takashi Terada
Nobuhiko Hiraiwa Takeshi Yuasa Masahiko Hasegawa
Since 1998, as a method of operating on descending thoracic aortic disease, especially distal aortic disease, a simple circulatory support technique, which uses the axillary artery or the ascending aorta as the aortic inflow, and the inferior vena cava for total body retrograde perfusion of cold oxygenated blood during circulatory arrest for open proximal anastomosis has been applied. This technique has been used in 25 consecutive cases over 10 years. In this report, we evaluate the efficacy of this support technique. From our experience, an atherosclerotic lesion in the ascending aorta required selection of the femoral artery as an aortic inflow site in 7 patients. Prolonged ventilatory support was unnecessary postoperatively unless neurological sequelae supervened, and no heart or visceral organ complications were occurred recognized. The hospital mortality rate was 16%. These results suggest our technique will continue to play an important role in operations on descending thoracic aortic diseases.
  Jpn. J. Cardiovasc. Surg. 39:9-13(2010)

Keywords:thoracic aortic surgery, left thoracotomy, deep hypothermia, total body retrograde perfusion