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The Annals of Thoracic Surgery, Vol 36, 19-28, Copyright © 1983 by The Society of Thoracic Surgeons
JJ Livesay, DA Cooley, GJ Reul, WE Walker, OH Frazier, JM Duncan and DA Ott
Hypothermic circulatory arrest has been used to facilitate resection of
aneurysms of the aortic arch. During a five-year period, two methods of
hypothermic arrest were compared in 60 patients. In Group 1, 20 patients
underwent deep hypothermia (14 degrees to 18 degrees C) and circulatory
arrest to allow repair of the transverse arch under optimal conditions. A
hospital mortality of 50% occurred and was attributed to uncontrolled
hemorrhage and cerebral or cardiac complications. In Group 2, modified
techniques were employed in 40 patients and included moderate levels of
hypothermia (22 degrees to 26 degrees C) and simplified operative methods,
which reduced the duration of circulatory arrest and shortened the length
of perfusion. Pretreatment of plasma- soaked Dacron grafts by autoclaving
eliminated serious bleeding problems. A marked improvement in patient
survival (90%) and reduction in postoperative complications were observed
after adoption of these modifications. The improved results in the present
series have reconfirmed our belief that this type of intervention is the
preferred approach to aneurysms of the aortic arch.
ARTICLES
Resection of aortic arch aneurysms: a comparison of hypothermic techniques in 60 patients
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