George Matalanis, MBMS, FRACS, Rhiannon S. Koirala, MBBS, William Y

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Drawings illustrating an extent II repair of a thoracoabdominal aortic aneurysm (A) that extends from the left subclavian artery to the aortoiliac bifurcation.

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Presentation transcript:

Branch-first aortic arch replacement with no circulatory arrest or deep hypothermia George Matalanis, MBMS, FRACS, Rhiannon S. Koirala, MBBS, William Y. Shi, MBBS, Philip A. Hayward, BMBCh, FRCS, Peter R. McCall, MBBS, FANZCA The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 4, Pages 809-815 (October 2011) DOI: 10.1016/j.jtcvs.2011.01.020 Copyright © 2011 Terms and Conditions

Figure 1 A, The innominate artery is clamped proximal to its bifurcation and distal to its origin from the arch and divided between the clamps. B, the innominate artery’s proximal stump is oversewn and the distal anastomosis to the first limb of the 3-branched graft is performed. C, The second limb of the branched Dacron graft is anastomosed to the carotid artery. D, The third limb is attached to the left subclavian artery. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 809-815DOI: (10.1016/j.jtcvs.2011.01.020) Copyright © 2011 Terms and Conditions

Figure 2 The descending aorta can be “clamped” in a number of ways: A, at the distal end of mobilization; B, through the posterior pericardium, behind the heart; or C, with intraluminal control with a balloon catheter. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 809-815DOI: (10.1016/j.jtcvs.2011.01.020) Copyright © 2011 Terms and Conditions

Figure 3 A, Distal body flow is changed from femoral to the sidearm graft. B, The trunk of the trifurcation graft is passed under the innominate vein and anastomosed to the arch graft. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 809-815DOI: (10.1016/j.jtcvs.2011.01.020) Copyright © 2011 Terms and Conditions