Continuous total body perfusion in complex aortic surgery.

Abstract

Background : Complex aortic surgery , especially involved arch aneurysm or other large aneurysm in thoracic part usually requires the use of deep hypothermia with circulatory arrest and brain protection using antegrade (Ueda 2000) or retrograde blood flow (Ueda 1999 , Safi 2001). Despite the application of these techniques , the surgeons may have difficulties in visualizing the operative field, require longer operative time, and increase the risk of postoperative multiple organs failure (Ehrlich 2000) . We describe a new perfusion technique in 7 patients, Prapokklao experience.

Materials and Methods : From July 2005 to July 2006 , 7 patients with an aneurysm of the aorta (1 thoracoabdominal aortic aneurysm , 3-dissecting aneurysm patients and 3 ruptured patients ) underwent a continuous total body perfusion during operation with mild to moderate hypothermia in 3-patients, normothermia in 4-patients by double inflow arterial line into right axillary artery and right femoral
artery (about 1:1 Y-connection)

Result : There were 2 operative , in-hospital mortalities. All other patients (5-patients) readily recovered with no neurologic sequelae , and postoperative courses were uneventful, without coagulopathy or hepato-renal impairment.

Conclusion : Total body perfusion by double inflow arterial line into Rt. Axillary artery and Rt. Femoral artery with mild to moderate hypothermia or normothermia is a relatively safe and reliable technique for all complex aortic aneurysm.

Key words : Aortic aneurysm, Double arterial inflow, Total body continuous perfusion