Presentation is loading. Please wait.

Presentation is loading. Please wait.

Moderate hypothermia, with partial bypass and segmental sequential repair for thoracoabdominal aortic aneurysm  Steven M. Frank, MD, Stephen D. Parker,

Published byAllison Sims Modified over 5 years ago

Similar presentations

Presentation on theme: "Moderate hypothermia, with partial bypass and segmental sequential repair for thoracoabdominal aortic aneurysm  Steven M. Frank, MD, Stephen D. Parker,"— Presentation transcript:

1 Moderate hypothermia, with partial bypass and segmental sequential repair for thoracoabdominal aortic aneurysm  Steven M. Frank, MD, Stephen D. Parker, MD, Peter Rock, MD, Randolph B. Gorman, MD, Susan Kelly, RN, Charles Beattie, MD, PhD, G.Melville Williams, MD  Journal of Vascular Surgery  Volume 19, Issue 4, Pages (April 1994) DOI: /S (94) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 Stage 1; completion of proximal anastomosis between graft and descending thoracic aorta just distal to origin of left subclavian artery. Left atrial to left common femoral bypass sustains perfusion of lower body. It also provides for rapid cooling to temperature of 30° C. Journal of Vascular Surgery  , DOI: ( /S (94) ) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 Stage 2; aorta, including two pairs of significant intercostal arteries, is being sutured for appropriately sized ellipse cut from graft. Spinal cord is likely to be ischemic during this interval. Journal of Vascular Surgery  , DOI: ( /S (94) ) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 Stage 3; large elliptical portion of aorta containing orifices of celiac axis, superior mesenteric and right renal arteries is shown being attached to oval defect cut from graft. Intercostal arteries are reperfused while kidneys and viscera are ischemic. At this stage rewarming is begun through femoral cannula. Journal of Vascular Surgery  , DOI: ( /S (94) ) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5 Fig. 4 Stage 4; distal anastomosis is shown being completed. Left renal artery has been attached to graft using short segment of PTFE. Atrial femoral bypass is activated intermittently simply to prevent clotting. After completion of this anastomosis, high flow atrial-femoral bypass is reinstituted to achieve normothermia. During this period of time, surgical hemostasis is achieved and decannulation carried out after 15 to 20 minutes of rewarming. Journal of Vascular Surgery  , DOI: ( /S (94) ) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

6 Fig. 5 Upper (tympanic) and lower (urinary bladder) core temperatures are shown at 5-minute intervals. Top panel (A) is from patient undergoing aortic valve replacement with full cardiopulmonary bypass from right atrium to ascending aorta. In this setting tympanic temperature responds more rapidly to changes in perfusion temperature. Bottom panel (B) is from patient undergoing thoracoabdominal aneurysm surgery with partial bypass from left atrium to left femoral artery. Response to cooling and rewarming is reversed in this setting, most likely from direct effects of perfusion temperature in femoral and pelvic vessels. Journal of Vascular Surgery  , DOI: ( /S (94) ) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

7 Fig. 6 Posterior tibial nerve somatosensory evoked cortical potentials at baseline (36° C) and hypothermic (30° C) temperatures demonstrating a 16% increase in latency with hypothermia but little change in amplitude. Journal of Vascular Surgery  , DOI: ( /S (94) ) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Download ppt "Moderate hypothermia, with partial bypass and segmental sequential repair for thoracoabdominal aortic aneurysm  Steven M. Frank, MD, Stephen D. Parker,"

Similar presentations

Neonatal thoracoabdominal aortic thrombosis associated with the umbilical artery catheter: Successful management by transaortic thrombectomy  Peter D.

Neonatal thoracoabdominal aortic thrombosis associated with the umbilical artery catheter: Successful management by transaortic thrombectomy  Peter D.
The risk of ischemic spinal cord injury in patients undergoing graft replacement for thoracoabdominal aortic aneurysms  Klaus Grabitz, MD, Wilhelm Sandmann,

The risk of ischemic spinal cord injury in patients undergoing graft replacement for thoracoabdominal aortic aneurysms  Klaus Grabitz, MD, Wilhelm Sandmann,
Ravi K. Ghanta, MD, John A. Kern, MD 

Ravi K. Ghanta, MD, John A. Kern, MD 
Thoracoabdominal Aneurysm Repair: A 20-Year Perspective

Thoracoabdominal Aneurysm Repair: A 20-Year Perspective
Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease  Joseph P. Archie, PhD, MD  Journal of Vascular.

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease  Joseph P. Archie, PhD, MD  Journal of Vascular.
Open Repair of Distal Aortic Arch and Proximal Descending Thoracic Aortic Aneurysm Using a Stepwise Distal Anastomosis  Hitoshi Ogino, MD  Operative Techniques.

Open Repair of Distal Aortic Arch and Proximal Descending Thoracic Aortic Aneurysm Using a Stepwise Distal Anastomosis  Hitoshi Ogino, MD  Operative Techniques.
Drawings illustrating an extent II repair of a thoracoabdominal aortic aneurysm (A) that extends from the left subclavian artery to the aortoiliac bifurcation.

Drawings illustrating an extent II repair of a thoracoabdominal aortic aneurysm (A) that extends from the left subclavian artery to the aortoiliac bifurcation.
James H. Black, MD, Richard P. Cambria, MD  Journal of Vascular Surgery 

James H. Black, MD, Richard P. Cambria, MD  Journal of Vascular Surgery 
Use of custom Dacron branch grafts for “hybrid” aortic debranching during endovascular repair of thoracic and thoracoabdominal aortic aneurysms  G. Chad.

Use of custom Dacron branch grafts for “hybrid” aortic debranching during endovascular repair of thoracic and thoracoabdominal aortic aneurysms  G. Chad.
Open Repair of Distal Aortic Arch and Proximal Descending Thoracic Aortic Aneurysm Using a Stepwise Distal Anastomosis  Hitoshi Ogino, MD  Operative Techniques.

Open Repair of Distal Aortic Arch and Proximal Descending Thoracic Aortic Aneurysm Using a Stepwise Distal Anastomosis  Hitoshi Ogino, MD  Operative Techniques.
Richard T. Purdy, M. D. , Frederick C. Beyer, M. D. , William D

Richard T. Purdy, M. D. , Frederick C. Beyer, M. D. , William D
Ravi K. Ghanta, MD, John A. Kern, MD 

Ravi K. Ghanta, MD, John A. Kern, MD 
A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without.

A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without.
Elective sac perfusion to reduce the risk of neurologic events following endovascular repair of thoracoabdominal aneurysms  Seamus C. Harrison, MRCS,

Elective sac perfusion to reduce the risk of neurologic events following endovascular repair of thoracoabdominal aneurysms  Seamus C. Harrison, MRCS,
Joseph S. Coselli, MD, Scott A. LeMaire, MD, Dwayne F

Joseph S. Coselli, MD, Scott A. LeMaire, MD, Dwayne F
Mycotic axillary artery aneurysm

Mycotic axillary artery aneurysm
Prevention of postoperative paraplegia during thoracoabdominal aortic surgery1  Yukio Kuniyoshi, MD, PhD, Kageharu Koja, MD, PhD, Kazufumi Miyagi, MD,

Prevention of postoperative paraplegia during thoracoabdominal aortic surgery1  Yukio Kuniyoshi, MD, PhD, Kageharu Koja, MD, PhD, Kazufumi Miyagi, MD,
Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair  Hazim J Safi, MD, Anders Winnerkvist, MD, Charles C Miller, PhD, Dimitrios.

Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair  Hazim J Safi, MD, Anders Winnerkvist, MD, Charles C Miller, PhD, Dimitrios.
Graft reconstruction to treat disease of the abdominal aorta in patients with colostomies, ileostomies, and abdominal wall urinary stomata  Ralph W. DeNatale,

Graft reconstruction to treat disease of the abdominal aorta in patients with colostomies, ileostomies, and abdominal wall urinary stomata  Ralph W. DeNatale,
Glomerular filtration rate is superior to serum creatinine for prediction of mortality after thoracoabdominal aortic surgery  Tam T.T. Huynh, MD, Randolph.

Glomerular filtration rate is superior to serum creatinine for prediction of mortality after thoracoabdominal aortic surgery  Tam T.T. Huynh, MD, Randolph.

Similar presentations

Ads by Google