Abstract
A technique is described for replacement of the entire thoracic aorta. In this "pull-through" technique, which utilizes hypothermic circulatory arrest, the graft is implanted in a retrograde fashion, thus providing protection for the spinal cord and brain and avoiding injury to the vagus and phrenic nerves.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BARNARD C. N., SCHRIRE V. The surgical treatment of acquired aneurysm of the throracic aorta. Thorax. 1963 Jun;18:101–115. doi: 10.1136/thx.18.2.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BIGELOW W. G., LINDSAY W. K., GREENWOOD W. F. Hypothermia; its possible role in cardiac surgery: an investigation of factors governing survival in dogs at low body temperatures. Ann Surg. 1950 Nov;132(5):849–866. doi: 10.1097/00000658-195011000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Berguer R., Porto J., Fedoronko B., Dragovic L. Selective deep hypothermia of the spinal cord prevents paraplegia after aortic cross-clamping in the dog model. J Vasc Surg. 1992 Jan;15(1):62–72. doi: 10.1067/mva.1992.33843. [DOI] [PubMed] [Google Scholar]
- Borst H. G., Walterbusch G., Schaps D. Extensive aortic replacement using "elephant trunk" prosthesis. Thorac Cardiovasc Surg. 1983 Feb;31(1):37–40. doi: 10.1055/s-2007-1020290. [DOI] [PubMed] [Google Scholar]
- COOLEY D. A., DEBAKEY M. E., MORRIS G. C., Jr Controlled extracorporeal circulation in surgical treatment of aortic aneurysm. Ann Surg. 1957 Sep;146(3):473–486. doi: 10.1097/00000658-195709000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooley D. A., Baldwin R. T. Technique of open distal anastomosis for repair of descending thoracic aortic aneurysms. Ann Thorac Surg. 1992 Nov;54(5):932–936. doi: 10.1016/0003-4975(92)90652-k. [DOI] [PubMed] [Google Scholar]
- Coselli J. S., Büket S., Djukanovic B. Aortic arch operation: current treatment and results. Ann Thorac Surg. 1995 Jan;59(1):19–27. doi: 10.1016/0003-4975(94)00812-L. [DOI] [PubMed] [Google Scholar]
- Crawford E. S., Coselli J. S., Safi H. J. Partial cardiopulmonary bypass, hypothermic circulatory arrest, and posterolateral exposure for thoracic aortic aneurysm operation. J Thorac Cardiovasc Surg. 1987 Dec;94(6):824–827. [PubMed] [Google Scholar]
- Crawford E. S., Coselli J. S., Svensson L. G., Safi H. J., Hess K. R. Diffuse aneurysmal disease (chronic aortic dissection, Marfan, and mega aorta syndromes) and multiple aneurysm. Treatment by subtotal and total aortic replacement emphasizing the elephant trunk operation. Ann Surg. 1990 May;211(5):521–537. doi: 10.1097/00000658-199005000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ergin M. A., Galla J. D., Lansman s. L., Quintana C., Bodian C., Griepp R. B. Hypothermic circulatory arrest in operations on the thoracic aorta. Determinants of operative mortality and neurologic outcome. J Thorac Cardiovasc Surg. 1994 Mar;107(3):788–799. [PubMed] [Google Scholar]
- Fisk G. C., Wright J. S., Hicks R. G., Anderson R. M., Turner B. B., Baker W. C., Lawrence L. C., Stacey R. B., Lawrie G. M., Kalnins I. The influence of duration of circulatory arrest at 20 degrees C on cerebral changes. Anaesth Intensive Care. 1976 May;4(2):126–134. doi: 10.1177/0310057X7600400208. [DOI] [PubMed] [Google Scholar]
- Griepp R. B., Stinson E. B., Hollingsworth J. F., Buehler D. Prosthetic replacement of the aortic arch. J Thorac Cardiovasc Surg. 1975 Dec;70(6):1051–1063. [PubMed] [Google Scholar]
- Kazui T., Inoue N., Yamada O., Komatsu S. Selective cerebral perfusion during operation for aneurysms of the aortic arch: a reassessment. Ann Thorac Surg. 1992 Jan;53(1):109–114. doi: 10.1016/0003-4975(92)90767-x. [DOI] [PubMed] [Google Scholar]
- Kouchoukos N. T., Wareing T. H., Izumoto H., Klausing W., Abboud N. Elective hypothermic cardiopulmonary bypass and circulatory arrest for spinal cord protection during operations on the thoracoabdominal aorta. J Thorac Cardiovasc Surg. 1990 Apr;99(4):659–664. [PubMed] [Google Scholar]
- Lillehei C. W., Todd D. B., Jr, Levy M. J., Ellis R. J. Partial cardiopulmonary bypass, hypothermia, and total circulatory arrest. A lifesaving technique for ruptured mycotic aortic aneurysms, ruptured left ventricle, and other complicated cardiac pathology. J Thorac Cardiovasc Surg. 1969 Oct;58(4):530–544. [PubMed] [Google Scholar]
- Massimo C. G., Presenti L. F., Favi P. P., Crisci C., Cruz Guadrón E. A. Simultaneous total aortic replacement from valve to bifurcation: experience with 21 cases. Ann Thorac Surg. 1993 Nov;56(5):1110–1116. doi: 10.1016/0003-4975(95)90026-8. [DOI] [PubMed] [Google Scholar]
- Nicks R. Aortic arch aneurysm. Resection and replacement: protection of the nervous system. Thorax. 1972 Mar;27(2):239–245. doi: 10.1136/thx.27.2.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PONTIUS R. G., BROCKMAN H. L., HARDY E. G., COOLEY D. A., DEBAKEY M. E. The use of hypothermia in the prevention of paraplegia following temporary aortic occlusion: experimental observations. Surgery. 1954 Jul;36(1):33–38. [PubMed] [Google Scholar]
- Pierangeli A., Coli G., Donati A., Galli R., Mikus P., Turinetto B. Treatment of aortic arch aneurysms with deep hypothermia and circulatory arrest. J Cardiovasc Surg (Torino) 1975 Jul-Aug;16(4):409–414. [PubMed] [Google Scholar]
- Scheinin S. A., Cooley D. A. Graft replacement of the descending thoracic aorta: results of "open" distal anastomosis. Ann Thorac Surg. 1994 Jul;58(1):19–23. doi: 10.1016/0003-4975(94)91065-0. [DOI] [PubMed] [Google Scholar]
- Svensson L. G., Crawford E. S., Hess K. R., Coselli J. S., Raskin S., Shenaq S. A., Safi H. J. Deep hypothermia with circulatory arrest. Determinants of stroke and early mortality in 656 patients. J Thorac Cardiovasc Surg. 1993 Jul;106(1):19–31. [PubMed] [Google Scholar]
- Treasure T., Naftel D. C., Conger K. A., Garcia J. H., Kirklin J. W., Blackstone E. H. The effect of hypothermic circulatory arrest time on cerebral function, morphology, and biochemistry. An experimental study. J Thorac Cardiovasc Surg. 1983 Nov;86(5):761–770. [PubMed] [Google Scholar]
- Yoshimura N., Ataka K., Okada M., Yamashita C., Yoshimura K., Kobayashi S. Ophthalmoscopic findings demonstrate reduced cerebral blood flow during retrograde cerebral perfusion. J Thorac Cardiovasc Surg. 1995 Mar;109(3):591–593. doi: 10.1016/S0022-5223(95)70295-4. [DOI] [PubMed] [Google Scholar]