Beating-heart total arch replacement for an octogenarian patient with severe heart failure.


Journal

Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 02 11 2020
accepted: 05 12 2020
pubmed: 9 1 2021
medline: 15 5 2021
entrez: 8 1 2021
Statut: ppublish

Résumé

Surgical outcomes of total arch replacement (TAR) have improved dramatically over the last decades. However, patients of advanced age and with a severely reduced cardiac function and an extended aortic arch aneurysm may not be candidates for conventional TAR. Endovascular and hybrid treatment for extended aortic aneurysm have demonstrated lower mortality and morbidity, and considered for the advanced age and high-risk patients. But endovascular with total de-branching technique remains challenging with the slightly dilated ascending aorta. Reducing the operation time, cardiac arrest time, and circulatory arrest time should be needed to resolve the problem for the conventional TAR with an advanced age and a severely reduced cardiac function. We herein introduce our surgical technique for the case of an 84-year-old man with a severely reduced cardiac function, who was successfully treated with beating heart TAR with minimization of the operation time, cardiac arrest time, and circulatory arrest time.

Identifiants

pubmed: 33416189
doi: 10.1111/jocs.15282
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1126-1129

Informations de copyright

© 2021 Wiley Periodicals LLC.

Références

Ikeno Y, Yokawa K, Yamanaka K, et al. Total arch replacement in octogenarians and nonagenarians: a single-center 18-year experience. J Thorac Cardiovasc Surg. 2020;160:346-356.e1
Minatoya K, Ogino H, Matsuda H, et al. Is conventional aortic arch surgery justifiable in octogenarians? J Thorac Cardiovasc Surg. 2010;139:641-645.
Ricci M, Macedo FIB, Suarez MR, Brown M, Alba J, Salerno TA. Multiple Valve surgery with beating heart technique. Ann Thorac Surg. 2009;87:527-531.
Berger T, Kreibich M, Rylski B, et al. Evaluation of myocardial injury, the need for vasopressors and inotropic support in beating-heart aortic arch surgery. J Cardiovasc Surg. 2019;61:505-511.
Martens A, Koigeldiyev N, Beckmann E, et al. Do not leave the heart arrested. Non-cardioplegic continuous myocardial perfusion during complex aortic arch repair improves cardiac outcome. Eur J Cardiothorac Surg. 2016;49:141-148.
Touati GD, Roux N, Carmi D, et al. Totally normothermic aortic arch replacement without circulatory arrest. Ann Thorac Surg. 2003;76:2115-2117.
Kopp R, Katada Y, Members of the AARCHIF registry, et al. Multicenter analysis of endovascular aortic arch in situ stent-graft fenestrations for aortic arch pathologies. Ann Vasc Surg. 2019;59:36-47.

Auteurs

Masato Mutsuga (M)

Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Hiroshi Banno (H)

Department of Vascular Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Yoshiyuki Tokuda (Y)

Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Akihiko Usui (A)

Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

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