Partial Clamping of the Brachiocephalic Trunk for Total Ascending Aorta Replacement without Circulatory Arrest: Early and Midterm Results

2004 ◽  
Vol 7 (3) ◽  
pp. E201-E207
Author(s):  
Antonio Maria Calafiore ◽  
Michele Di Mauro ◽  
Carlos-A. Mestres ◽  
Gabriele Di Giammarco ◽  
Giovanni Teodori ◽  
...  
Keyword(s):  
Circulatory Arrest ◽  
Ascending Aorta ◽  
Midterm Results ◽  
Brachiocephalic Trunk ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

Bloodless aortic valve and ascending aorta replacement surgery requiring circulatory arrest: two case studies

Perfusion ◽  
2009 ◽  
Vol 24 (3) ◽  
pp. 203-205
Author(s):  
David M. Schill
Keyword(s):  
Aortic Valve ◽  
Blood Product ◽  
Circulatory Arrest ◽  
Venous Drainage ◽  
Ascending Aorta ◽  
Clotting Factors ◽  
Replacement Surgery ◽  
Cardiac Procedures ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

Blood and/or blood product transfusions are common during and after complicated cardiac procedures. Replacement of the aortic valve, ascending aorta, and coronary implantation requiring circulatory arrest are high-risk procedures. Blood product transfusions only add to the morbidity and mortality rates associated with these types of procedures. Perfusion strategies must be incorporated to decrease the effects of hemodiluton due to cardiopulmonary bypass (CPB), and preserve platelets and clotting factors needed for hemostasis, post-operatively. We are reporting two consecutive cases where the patients presented with aortic valve stenosis accompanying an ascending aortic aneurysm requiring surgical correction using circulatory arrest. Neither patient required any blood or blood product donation throughout their hospital stay. Our strategies included minimizing our bypass circuit, utilization vacuum-assisted venous drainage, plasma sequestration, total circuit retrograde autologous priming (RAP), and cell salvage.

Intravascular Ultrasound Findings of BioGlue Surgical Adhesive Coronary Embolism After Ascending Aorta Replacement

2021 ◽  
Vol 14 (4) ◽  
pp. e39-e41
Author(s):  
Masashi Yokoi ◽  
Hiroshi Fujita ◽  
Tatsuhito Ogawa ◽  
Tsuyoshi Ito ◽  
Yoshihiro Seo ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Ascending Aorta ◽  
Surgical Adhesive ◽  
Ultrasound Findings ◽  
Aorta Replacement ◽  
Coronary Embolism ◽  
Ascending Aorta Replacement

Early safety performance of a modified technique of aorta replacement with sinotubular stabilization

2021 ◽  
pp. 021849232110150
Author(s):  
Marco Moscarelli ◽  
Nicola Di Bari ◽  
Giuseppe Nasso ◽  
Khalil Fattouch ◽  
Thanos Athanasiou ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Aortic Insufficiency ◽  
Ascending Aorta ◽  
Safety Performance ◽  
Modified Technique ◽  
Sinotubular Junction ◽  
Aorta Replacement ◽  
Valve Sparing ◽  
Ascending Aorta Replacement

Background We sought to determine if a modified technique for ascending aorta replacement with sinotubular junction reduction and stabilization was safe. Methods This technique was performed by suspension of the three commissures, invagination of the aortic Dacron graft and advancing the graft into the ventricles. We included patients with dilatation of the ascending aorta, normal sinuses of Valsalva dimension (<45 mm), with or without aortic annulus enlargement (>25 mm) and with various degree of aortic insufficiency (from grade 1 to 3). Results From April to October 2019, 20 patients were recruited from two centers; mean age was 66.9 ± 12.8 years, 13 were male; grade 1, 2 and 3 was present in 12, 2 and 6 patients, respectively. All patients underwent ascending aorta replacement with modified technique; an additional open subvalvular ring was used in 8 patients with aortic insufficiency ≥ 2; cusps repair was performed in 6 patients (5 plicating central stitches/1 shaving); concomitant coronary artery bypass grafting was performed in 10 patients. There was no 30-day mortality. One patient was re-explored for bleeding. All patients completed six-month follow-up; at the transthoracic echocardiography, there was no aortic insufficiency ≥ 1 except one patient with aortic insufficiency grade 1 who underwent ascending aorta replacement and subvalvular ring; no patients underwent reintervention. Conclusions This modified technique for ascending aorta replacement and sinotubular junction stabilization was safe. It could be associated with other aortic valve sparing techniques. However, such remodeling approach has to be validated in a larger cohort of patients with longer follow-up.

scholarly journals Fate of mild-to-moderate bicuspid aortic valve disease untreated during ascending aorta replacement

2020 ◽  
Author(s):  
Alessandro Verzini ◽  
Marta Bargagna ◽  
Guido Ascione ◽  
Alessandra Sala ◽  
Davide Carino ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Ascending Aorta ◽  
Term Survival ◽  
Kaplan Meier ◽  
Aortic Root Surgery ◽  
Increased Risk ◽  
Aorta Replacement ◽  
Ascending Aorta Replacement

Background: Bicuspid aortic valve (BAV) is the most common congenital heart defect and it is responsible for an increased risk of developing aortic valve and ascending aorta complications. In case of mild to moderate BAV disease in patients undergoing supracoronary ascending aorta replacement, it is unclear whether a concomitant aortic valve replacement should be performed. Methods: From June 2002 to January 2020, 75 patients with mild-to-moderate BAV regurgitation (± mild-to-moderate stenosis) who underwent isolated supracoronary ascending aorta replacement were retrospectively analyze. Clinical and echocardiographic follow-up was 100% complete (mean: 7.4±3.9 years, max 16.4). Kaplan Meier estimates were employed to analyze long-term survival. Cumulative incidence function for time to re-operation, recurrence of aortic regurgitation (AR)≥3+ and aortic stenosis (AS) greater than moderate, with death as competing risk, were computed. Results: There was no hospital mortality and no cardiac death occurred. Overall survival at 12 years was 97.4±2.5%, 95% CI [83.16-99.63]. At follow-up there were no cases of aortic root surgery whereas 3 patients underwent AV replacement. At 12 years the CIF of reoperation was 2.6±2.5%, 95% CI [0.20-11.53]. At follow up, AR 3+/4+ was present in 1 pt and AS greater than moderate in 3. At 12 years the CIF of AR>2+/4+ was 5.1±4.98% and of AS>moderate 6.9±3.8%. Conclusions: In our study mild to moderate regurgitation of a BAV did not significantly worse at least up to 10 years after isolated supracoronary ascending aorta replacement.

Anesthetic management for ascending aorta replacement in a patient who refused autologous transfusion for religious reasons

2009 ◽  
Vol 23 (3) ◽  
pp. 436-438 ◽  
Author(s):  
Shinju Obara ◽  
Masayuki Nakagawa ◽  
Shinichiro Takahashi ◽  
Masahiko Akatu ◽  
Tsuyoshi Isosu ◽  
...  
Keyword(s):  
Anesthetic Management ◽  
Ascending Aorta ◽  
Autologous Transfusion ◽  
Aorta Replacement ◽  
Religious Reasons ◽  
Ascending Aorta Replacement
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