1. Aneurysm Repair with Involvement of the Great Vessels off the Aortic Arch
R.Lowery MD/ WHC

2. Robert C. Lowery, MD
Salary:
St. Jude Medical, Inc.

3. Type A Dissection Belongs to Cardiothoracic Surgery: Is there a Place for Vascular Surgery?
Sean D. O'Donnell, MD
CT vs Vascular

5. Brain or Heart?
WHAT DO WE DO THESE DAYS RE SURGERY OF THE THORACIC AORTA?
The adult brain represents only 4% of body mass, but requires 20% of the entire arterial blood flow. Two fundamental concepts derive from this physiologic fact. First, clinically important oxygen imbalance in a single brain region may be invisible to whole-body or even whole-head measures of oxygenation. This explains the oft-reported finding that neither blood pressure nor arterial oxygen saturation is predictive of post-surgical neurocognitive outcome.6 Second, correction of brain regional imbalance should also benefit other vital organs, because of their lower oxygen requirements
Of all vital organs, the brain is unique in its ability to maintain, during cardiopulmonary bypass, precise regulation of blood flow to match local metabolic demand. This cerebral autoregulation assures adequate blood flow despite moderate declines in blood pressure. Unfortunately, autoregulation is diminished or absent in a minority of patients due to pre-existing disease or the effects of anesthesia and/or extracorporeal circulation. In these patients, relatively small decreases in blood pressure may cause marked reduction of cerebral blood flow

7. AXILLARY CANNULATION

9. AORTIC ANEURYSM

10. AORTIC ANEURYSMS

13. AORTIC ANEURYSMS
Ford: Tevar of Kummeral’s diverticulum

21. Matthew J. Metcalfe, MD, MRCS, Alan Karthikesalingam, MRCS,
? FUTURE
Case report
The first endovascular repair of an acute type A dissection using an endograft designed for the ascending aorta
Matthew J. Metcalfe, MD, MRCS,Alan Karthikesalingam, MRCS,
Steve A. Black, FRCS, Ian M. Loftus, MD, FRCS, Robert Morgan, FRCR, Matt M. Thompson, MD, FRCS ,
St George's Vascular Institute, St George's Healthcare NHS Trust, London, United Kingdom
Received 16 May Accepted 28 June Available online 9 September 2011.
Via the CFA, a 34-mm-diameter Zenith Ascending Dissection device (Cook Medical, Bjaeverskov, Denmark) was positioned across the aortic valve over a Lunderquist extra-stiff guidewire (Cook Medical). With overdrive pacing-induced hypotension, the stent (Fig 2) was withdrawn and deployed in the ascending aorta. Angiography confirmed exclusion of the false lumen with patency of both coronary and innominate arteries. After surgery, the patient was extubated within 24 hours. A CT scan confirmed satisfactory coverage of the intimal tear with no contrast extravasation (Fig 3).
Journal of Vascular Surgery
Volume 55, Issue 1, January 2012
The first endovascular repair of an acute type A dissection using an endograft designed for the ascending aorta
Matthew J. Metcalfe, MD, MRCS,
Alan Karthikesalingam, MRCS,
Steve A. Black, FRCS,
Ian M. Loftus, MD, FRCS,
Robert Morgan, FRCR,
Matt M. Thompson, MD, FRCS ,
St George's Vascular Institute, St George's Healthcare NHS Trust, London, United Kingdom
Received 16 May Accepted 28 June Available online 9 September 2011.

22. ? FUTURE

23. SUPERBOWL SUNDAY

24. THANK YOU

25. Slide Title
Level One bullet
Level Two bullet
Level Three bullet

27. Mr Floyd’s operation