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Arch-first technique for aortic arch aneurysm repair through median sternotomy  Motonobu Nishimura, MD, Shigeaki Ohtake, MD, Yoshiki Sawa, MD, Toshiki.

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Presentation on theme: "Arch-first technique for aortic arch aneurysm repair through median sternotomy  Motonobu Nishimura, MD, Shigeaki Ohtake, MD, Yoshiki Sawa, MD, Toshiki."— Presentation transcript:

1 Arch-first technique for aortic arch aneurysm repair through median sternotomy 
Motonobu Nishimura, MD, Shigeaki Ohtake, MD, Yoshiki Sawa, MD, Toshiki Takahashi, MD, Goro Matsumiya, MD, Koji Kagisaki, MD, Yuji Miyamoto, MD, Hikaru Matsuda, MD, PhD  The Annals of Thoracic Surgery  Volume 74, Issue 4, Pages (October 2002) DOI: /S (02)

2 Fig 1 Schema of our arch-first technique of total arch replacement with a branched aortic arch graft. (A) Start cardiopulmonary bypass with arterial blood return to right subclavian artery. (B) After cooling, the arch vessels are reconstructed separately during circulatory arrest. (C) Cerebral perfusion is re-started and distal anastomosis is performed using separate graft. (D) Distal perfusion is re-started through femoral artery and the two grafts are attached. (E) Whole arterial blood return switched to one of the branches of the graft and the proximal anastomosis is performed. (F) Completion of the procedure. The Annals of Thoracic Surgery  , DOI: ( /S (02) )

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