えっ? 手術が3時間?はい、全弓部置換術でも翌日歩行できます。




Total Arch Replacement with Selective Antegrade Cerebral Perfusion


Aneurysm of the aortic arch has been the most difficult problem for cardiovascular surgeons. Especially the deep operative field of the distal aortic anastomosis and the subclavian artery reconstruction are technically demanding parts of the procedure. Here we present our standard approach for this pathology, presented at NY Aortic Symposium 2016. Complete elimination of CVA and SCI is achieved using epiaortic assessment of the aortic cannulation site and introduction of three selective cerebral perfusion catheters following sharp dissection of epiaortic branches. Left pleural space entry and division of the ligamntum arteriosum are liberally utilized to facilitate the procedure. Routine operation takes about less than 2 hours of cardioplumonary bypass, and 3 hour of skin-to-skin time. This is achieved with thorough understanding of local anatomy and pathology.