Open distal anastomosis or aortic balloon occlusion technique during complete aortic arch replacement

1998 ◽  
Vol 46 (7) ◽  
pp. 610-615
Author(s):  
Mitsuaki Sadahiro ◽  
Masahiro Sakurai ◽  
Masaki Hata ◽  
Yoshihiro Sawamura ◽  
Izuru Yoshida ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Balloon Occlusion ◽  
Distal Anastomosis ◽  
Aortic Arch Replacement ◽  
Aortic Balloon Occlusion ◽  
Occlusion Technique ◽  
Balloon Occlusion Technique

scholarly journals The strategy of cardiopulmonary bypass for total aortic arch replacement and the frozen elephant trunk technique with aortic balloon occlusion

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052090541
Author(s):  
Yunfeng Li ◽  
Shujie Yan ◽  
Song Lou ◽  
Xiaogang Sun
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Balloon Occlusion ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement ◽  
Aortic Balloon Occlusion ◽  
Occlusion Technique ◽  
Balloon Occlusion Technique

Objective To investigate the use of the aortic balloon occlusion technique to assist total aortic arch replacement (TAR) with frozen elephant trunk (FET) to shorten the lower body circulatory arrest (CA) time and raise the nadir temperature during cardiopulmonary bypass. Methods This retrospective study reviewed consecutive patients that underwent aortic balloon occlusion to assist TAR with FET and patients that received conventional TAR with FET procedures. Preoperative characteristics, perioperative characteristics and postoperative outcomes were compared between the two groups. Results The study included130 patients treated with aortic balloon occlusion and 230 patients treated with conventional TAR with FET. The 30-day mortality rate was similar between the aortic balloon occlusion and conventional groups (4.62% versus 7.83%, respectively). Multivariate analysis showed that aortic balloon occlusion reduced the incidence of acute kidney injury, hepatic injury and red blood cell transfusion. The application of aortic balloon occlusion reduced the mean ± SD CA time from 17.24 ± 4.36 min to 6.33 ± 5.74 min, with the target nadir nasal temperature being increased from 25°C to 28°C. Conclusion The aortic balloon occlusion technique achieved significant improvements in reducing complications, but this did not translate into lower 30-day mortality.

scholarly journals Risk Factor Analysis of Clinical Outcomes of Total Aortic Arch Replacement and Frozen Elephant Trunk With Aortic Balloon Occlusion

2021 ◽  
Author(s):  
Luchen Wang ◽  
Yunfeng Li ◽  
Yaojun Dun ◽  
Xiaogang Sun
Keyword(s):  
Hospital Stay ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Balloon Occlusion ◽  
Conventional Group ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement ◽  
Aortic Balloon Occlusion

Abstract Background: Total aortic arch replacement (TAR) with frozen elephant trunk (FET) requires hypothermic circulatory arrest (HCA) for 20 minutes, which increases the surgical risk. We invented an aortic balloon occlusion technique that requires 5 minutes of HCA on average to perform TAR with FET and investigated the possible merit of this new method in this study. Methods: This retrospective study included consecutive patients who underwent TAR and FET (consisting of 130 cases of aortic balloon occlusion group and 230 cases of conventional group) in Fuwai Hospital between August 2017 and February 2019. In addition to the postoperative complications, the alterations of blood routine tests, alanine transaminase (ALT) and aspartate transaminase (AST) during the in-hospital stay were also recorded. Results: The 30-day mortality rates were similar between the aortic balloon occlusion group (4.6%) and the conventional group (7.8%, P = 0.241). Multivariate analysis showed aortic balloon occlusion reduced postoperative acute kidney injury (23.1% vs 35.7%, P = 0.013) and hepatic injury (12.3% vs 27.8%, P = 0.001), and maintained similar cost to patients (25.5 vs 24.9 kUSD, P = 0.298). We also found that AST was high during intensive care unit (ICU) stay and recovered to normal before discharge, while ALT was not as high as AST in ICU but showed a rising tendency before discharge. The platelet count showed a rising tendency on postoperative day 3 and may exceed the preoperative value before discharge. Conclusions: The aortic balloon occlusion achieved the surgical goal of TAR with FET with an improved recovery process during the in-hospital stay.

The intraoperative use of aortic balloon occlusion technique for sacral and pelvic tumor resections: A case-control study

2020 ◽  
Vol 32 ◽  
pp. 69-74 ◽  
Author(s):  
Nicola Ratto ◽  
Michele Boffano ◽  
Pietro Pellegrino ◽  
Andrea Conti ◽  
Laura Rossi ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Balloon Occlusion ◽  
Pelvic Tumor ◽  
Aortic Balloon Occlusion ◽  
Occlusion Technique ◽  
Control Study ◽  
Balloon Occlusion Technique

Perfusion management of aortic balloon occlusion technique in total arch replacement with frozen elephant trunk

Perfusion ◽  
2019 ◽  
Vol 35 (4) ◽  
pp. 280-283
Author(s):  
Shujie Yan ◽  
Xiaogang Sun ◽  
Hongwei Guo ◽  
Yunfeng Li ◽  
Yu Zhao ◽  
...  
Keyword(s):  
Balloon Catheter ◽  
Balloon Occlusion ◽  
Total Arch Replacement ◽  
Lower Body ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Aortic Balloon Occlusion ◽  
Occlusion Technique ◽  
Balloon Occlusion Technique

To ensure both cerebral and lower body perfusion during total arch replacement with frozen elephant trunk, aortic balloon occlusion technique has been applied in some cases at our institute. During the procedure, after stented elephant trunk is inserted into the true lumen of the descending aorta, an aortic balloon catheter is placed and inflated within the stented elephant trunk, occluding the orifice of descending aorta. Then, lower body perfusion is provided via femoral cannulae during distal aortic arch anastomosis. We describe the perfusion management strategy of the technique, elucidate intraoperative monitoring parameters, and clarify the feasibility of the method from the aspect of perfusion.

scholarly journals Improvement of Clinical Outcomes of Total Aortic Arch Replacement and Frozen Elephant Trunk Surgery With Aortic Balloon Occlusion

2021 ◽  
Vol 8 ◽  
Author(s):  
Luchen Wang ◽  
Zeyi Cheng ◽  
Yunfeng Li ◽  
Junpeng Li ◽  
Hongwei Guo ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Clinical Outcomes ◽  
Complication Rate ◽  
Balloon Occlusion ◽  
Conventional Approach ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement ◽  
Aortic Balloon Occlusion

Background: Total aortic arch replacement (TAR) with frozen elephant trunk (FET) surgery provides improved long-term results, but the surgery itself is associated with higher risks compared with isolated proximal reconstructions. We applied an aortic balloon occlusion (ABO) technique to reduce the circulatory arrest (CA) time and improve other clinical outcomes.Methods: All patients who underwent TAR with FET surgery (130 with ABO technique, 230 with the conventional approach) in Fuwai Hospital from August 2017 to February 2019 were reviewed in this retrospective observational cohort study. Intra- and early-postoperative results and clinical characteristics were analyzed.Results: After 1:1 propensity score matching (130 cases in each group), the 30-day mortality of the ABO group and the conventional group were 4.6% and 10.8% (p = 0.063), respectively. Although the reduction in complications was not statistically significant, the complication rate in the ABO group was relatively low, having fewer cases of postoperative renal (23.1 vs. 38.5%, p = 0.007) and hepatic (12.3 vs. 30.0%, p < 0.001) injury, lower postoperative wake-up time (15.2 ± 23.6 h vs. 20.1 ± 26.5 h, respectively, p < 0.001), reduced chest tube output (176.03 ± 143.73 ml vs. 213.29 ± 130.12 ml, respectively, p = 0.003), lower red blood cell transfusion volume (4.98 ± 6.53 u vs. 7.28 ± 10.41 u, respectively, p = 0.008), and no fatal events.Conclusions: The ABO technique is a simple method that can reduce the CA time and improve the recovery stage following TAR with FET surgery. The technique represents a practical strategy to treat patients with high operative risks due to its lower complication rate compared with the conventional approach.

scholarly journals Aortic balloon occlusion catheter with perfusion lumen for protection of lower body during distal anastomosis in aortic arch repair

2002 ◽  
Vol 123 (5) ◽  
pp. 1006-1008 ◽  
Author(s):  
Hisato Takagi ◽  
Yoshio Mori ◽  
Hisashi Iwata ◽  
Yukio Umeda ◽  
Yukihiro Matsuno ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Balloon Occlusion ◽  
Distal Anastomosis ◽  
Lower Body ◽  
Aortic Balloon Occlusion ◽  
Aortic Arch Repair

scholarly journals Risk factor analysis of clinical outcomes of total aortic arch replacement and frozen elephant trunk with aortic balloon occlusion

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Luchen Wang ◽  
Yunfeng Li ◽  
Yaojun Dun ◽  
Xiaogang Sun
Keyword(s):  
Hospital Stay ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Balloon Occlusion ◽  
Conventional Group ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement ◽  
Aortic Balloon Occlusion

Abstract Background Total aortic arch replacement (TAR) with frozen elephant trunk (FET) requires hypothermic circulatory arrest (HCA) for 20 min, which increases the surgical risk. We invented an aortic balloon occlusion (ABO) technique that requires 5 min of HCA on average to perform TAR with FET and investigated the possible merit of this new method in this study. Methods This retrospective study included consecutive patients who underwent TAR and FET (consisting of 130 cases of ABO group and 230 cases of conventional group) in Fuwai Hospital between August 2017 and February 2019. In addition to the postoperative complications, the alterations of blood routine tests, alanine transaminase (ALT) and aspartate transaminase (AST) during in-hospital stay were also recorded. Results The 30-day mortality rates were similar between ABO group (4.6%) and conventional group (7.8%, P = 0.241). Multivariate analysis showed ABO reduced postoperative acute kidney injury (23.1% vs. 35.7%, P = 0.013) and hepatic injury (12.3% vs. 27.8%, P = 0.001), and maintained similar cost to patients (25.5 vs. 24.9 kUSD, P = 0.298). We also found that AST was high during intensive care unit (ICU) stay and recovered to normal before discharge, while ALT was not as high as AST in ICU but showed a rising tendency before discharge. The platelet count showed a rising tendency on postoperative day 3 and may exceed the preoperative value before discharge. Conclusions The ABO achieved the surgical goal of TAR with FET with an improved recovery process during the in-hospital stay.

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