Technique and rationale for branch-first total aortic arch repairCentral MessagePerspective
Objective: Our objective was to describe the technique and rationale for branch-first total aortic arch repair. Methods: Branch-first total aortic arch repair involves serial clamping, reconstruction, and reperfusion of each of the arch branches using a specially designed trifurcation graft with a s...
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| Language: | English |
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Elsevier
2020-12-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250720305198 |
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| author | Michelle Kim, MBBS George Matalanis, MBBS, MS, FRACS |
| author_facet | Michelle Kim, MBBS George Matalanis, MBBS, MS, FRACS |
| author_sort | Michelle Kim, MBBS |
| collection | DOAJ |
| description | Objective: Our objective was to describe the technique and rationale for branch-first total aortic arch repair. Methods: Branch-first total aortic arch repair involves serial clamping, reconstruction, and reperfusion of each of the arch branches using a specially designed trifurcation graft with a side port. During this sequence, perfusion to the heart and distal organs are preserved and continuous antegrade cerebral perfusion is permitted via the trifurcation graft. The diseased aorta is excised and replaced with a Dacron graft (W.L. Gore and Associates, Newark, Del) with a perfusion side port. The trifurcation graft is anastomosed to the new proximal ascending aorta. Results: The branch-first technique permits total aortic arch repair without global cerebral circulatory arrest and excessive hypothermia. It shortens distal organ and cardiac ischemic time, and reduces the opportunity for air and particulate embolization during aortic repair. Conclusions: Branch-first total aortic arch repair allows continuous antegrade cerebral perfusion and shortens distal organ and cardiac ischemic time, with unobstructed access to the full extent of the diseased aortic arch. |
| format | Article |
| id | doaj-art-4a085ee1c093456d8d61b2c017e8f834 |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-4a085ee1c093456d8d61b2c017e8f8342025-08-20T03:36:37ZengElsevierJTCVS Techniques2666-25072020-12-0141410.1016/j.xjtc.2020.09.014Technique and rationale for branch-first total aortic arch repairCentral MessagePerspectiveMichelle Kim, MBBS0George Matalanis, MBBS, MS, FRACS1Address for reprints: Michelle Kim, MBBS, Department of Cardiac Surgery, Austin Health, 145 Studley Road, Heidelberg, Melbourne, Victoria, Australia.; Department of Cardiac Surgery, Austin Health, Melbourne, AustraliaDepartment of Cardiac Surgery, Austin Health, Melbourne, AustraliaObjective: Our objective was to describe the technique and rationale for branch-first total aortic arch repair. Methods: Branch-first total aortic arch repair involves serial clamping, reconstruction, and reperfusion of each of the arch branches using a specially designed trifurcation graft with a side port. During this sequence, perfusion to the heart and distal organs are preserved and continuous antegrade cerebral perfusion is permitted via the trifurcation graft. The diseased aorta is excised and replaced with a Dacron graft (W.L. Gore and Associates, Newark, Del) with a perfusion side port. The trifurcation graft is anastomosed to the new proximal ascending aorta. Results: The branch-first technique permits total aortic arch repair without global cerebral circulatory arrest and excessive hypothermia. It shortens distal organ and cardiac ischemic time, and reduces the opportunity for air and particulate embolization during aortic repair. Conclusions: Branch-first total aortic arch repair allows continuous antegrade cerebral perfusion and shortens distal organ and cardiac ischemic time, with unobstructed access to the full extent of the diseased aortic arch.http://www.sciencedirect.com/science/article/pii/S2666250720305198total aortic arch repairaortic arch replacementantegrade cerebral perfusionbranch-first |
| spellingShingle | Michelle Kim, MBBS George Matalanis, MBBS, MS, FRACS Technique and rationale for branch-first total aortic arch repairCentral MessagePerspective JTCVS Techniques total aortic arch repair aortic arch replacement antegrade cerebral perfusion branch-first |
| title | Technique and rationale for branch-first total aortic arch repairCentral MessagePerspective |
| title_full | Technique and rationale for branch-first total aortic arch repairCentral MessagePerspective |
| title_fullStr | Technique and rationale for branch-first total aortic arch repairCentral MessagePerspective |
| title_full_unstemmed | Technique and rationale for branch-first total aortic arch repairCentral MessagePerspective |
| title_short | Technique and rationale for branch-first total aortic arch repairCentral MessagePerspective |
| title_sort | technique and rationale for branch first total aortic arch repaircentral messageperspective |
| topic | total aortic arch repair aortic arch replacement antegrade cerebral perfusion branch-first |
| url | http://www.sciencedirect.com/science/article/pii/S2666250720305198 |
| work_keys_str_mv | AT michellekimmbbs techniqueandrationaleforbranchfirsttotalaorticarchrepaircentralmessageperspective AT georgematalanismbbsmsfracs techniqueandrationaleforbranchfirsttotalaorticarchrepaircentralmessageperspective |