Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > The Journal of Cardiovascular Surgery 1998 August;39(4) > The Journal of Cardiovascular Surgery 1998 August;39(4):399-404

ULTIMO FASCICOLO
 

ARTICLE TOOLS

Estratti

THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,179


eTOC

 

ORIGINAL ARTICLES  VASCULAR PAPERS


The Journal of Cardiovascular Surgery 1998 August;39(4):399-404

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Surgical results for thoraco-abdominal aneurysm by modified DeBakey method using centrifugal biopump and renal cryopreservation

Yamashita Ch., Okada M., Ataka K., Yoshida M., Nohara H., Azami T., Yamashita T., Ozaki N.

From the Department of Surgery, Division II Kobe University School of Medicine, Kobe, Japan


PDF  


Background. In ­this ­paper, we ­report the sur­gi­cal ­results of our DeBakey and Crawford com­bined meth­od.
Methods. From 1985 to 1995, 22 con­sec­u­tive ­patients ­with thor­a­co-ab­dom­i­nal aneu­rysms under­went a mod­i­fied DeBakey and Crawford com­bined pro­ce­dure to min­i­mize the ischem­ic ­time for the spi­nal ­cord and vis­cer­al ­organs. The ­extent of aneu­rysm as clas­si­fied by Crawford was as fol­lows: ­Group I, 12; ­Group II, 4, ­Group III, 3; ­Group IV, 3. The eti­ol­o­gy of the aneu­rysm was ath­ero­scler­o­sis in 19, cys­tic medi­al necro­sis in 2, and aor­titis in 1. The aneu­rysm was ­approached ­through the spi­ral open­ing meth­od. First, end-to-­side dis­tal anas­tom­o­sis was per­formed ­above the bifur­ca­tion ­under par­tial aor­tic clamp­ing, and ­this was fol­lowed by prox­i­mal anas­tom­o­sis. During the end-to-end prox­i­mal anas­tom­o­sis, a Gott ­shunt ­tube or hep­a­rin­less ­left ­heart ­bypass was ­used. In two ­patients, ­left ­renal ­artery had ­been pre­vi­ous­ly recon­struct­ed by a saph­e­nous ­vein ­graft extend­ing ­from the ­left com­mon ­iliac ­artery. Then aneu­rysm was ­opened, and the ­right ­renal ­artery and super­i­ors mes­en­ter­ic ­artery ­were per­fused ­with ­cold ­blood. In two ­patients, par­tial car­di­o­pul­mo­nary ­bypass and selec­tive per­fu­sion ­were per­formed. In ­eight patien­ti, ­renal ­artery, ­celiac ­artery, super­i­or mes­en­ter­ic ­artery, and inter­cos­tal ­artery ­were recon­struct­ed ­with a ­branch ­graft.
Results. No ­patient ­died with­in 30 ­days of sur­gery, how­ev­er, one ­patient ­died of ­acute myo­car­dial infarc­tion (POD 54) and ­another of ven­tric­u­lar fib­ril­la­tion dur­ing hemo­di­al­y­sis (POD 60). Postoperative com­pli­ca­tions includ­ed par­a­ple­gia, and ­renal fail­ure requir­ing dial­y­sis ­each in two ­patients. Postoperative angio­gra­phy ­revealed 18/19 (94.7%) of ­grafts ­were pat­ent.
Conclusions. In con­clu­sion, by ­using dif­fer­ent tech­niques for spi­nal ­cord and vis­cer­al pro­tec­tion, includ­ing the Gott ­shunt, Biomedicus ­pump, ­renal cryo­pres­er­va­tion, and sep­ar­ate revas­cu­lar­iza­tion of vis­ce­ra and inter­cos­tal arter­ies, ­good ­results ­could be ­obtained.

inizio pagina

Publication History

Per citare questo articolo

Corresponding author e-mail