Antegradely insertable aortic balloon occlusion catheter for aortic arch repair |
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Authors: | Hisato Takagi Hajime Hirose Yoshio Mori Hisashi Iwata Yukio Umeda Yukihiro Matsuno |
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Institution: | (1) First Department of Surgery, Gifu University School of Medicine, 40 Tsukasa, Gifu 500-8705, Japan, JP |
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Abstract: | We have developed an antegradely insertable aortic balloon occlusion catheter for aortic arch repair, and review our experiences
of using it. The purpose of the present study was to examine the usefulness of the balloon for surgical treatment of aortic
arch aneurysm. In 30 patients with aortic arch aneurysm, including 22 with a non-ruptured and 8 with a ruptured aneurysm,
the catheter was antegradely inserted into the descending thoracic aorta through the aortic arch or the aneurysm without opening
the pleural space after establishing antegrade selective cerebral perfusion and obtaining cardiac arrest. During distal anastomosis,
the catheter occluded the aorta with continuous perfusion of the lower half of the body through an arterial cannula inserted
into the femoral artery. Among the patients with a nonruptured aneurysm, two deaths (9.1%) occurred because of aorto-broncho-esophageal
fistulae or cardiac arrest due to severe asthma attack within 30 days, and the other three hospital deaths were due to aspiration
pneumonia, multiple organ failure with preoperative renal dysfunction, or low cardiac output syndrome due to perioperative
myocardial infarction. Among the patients with a ruptured aneurysm, three deaths (37.5%) were due to acute myocardial infarction,
respiratory failure, or intractable arrhythmia within 30 days, and another hospital death was caused by mediastinitis. No
paraplegia was caused in any patient excluding one of the patients with a ruptured aneurysm who could not be weaned from the
extracorporeal circulation due to perioperative myocardial infarction. There was no early postoperative serious visceral organ
dysfunction except for two patients with postoperative low cardiac output syndrome or preoperative severe renal dysfunction.
This catheter was effective in protecting the visceral organs and the spinal cord in the repair of an aortic arch aneurysm.
Received: March 7, 2002 / Accepted: November 29, 2002 |
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Keywords: | Antegradely insertable Aortic balloon occlusion catheter Aortic arch repair |
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