Reoperation for a type I aortic dissection: case report

Surgery for the repair of a type I aortic dissection presents several difficulties for the surgeon and the perfusionist. One must safely support the patient, while at the same time provide the surgeon with a bloodless field in which to operate. Often, this requires cessation of the circulation for v...

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Bibliographic Details
Published in:Perfusion 2000-03, Vol.15 (2), p.155-159
Main Authors: Wise, Robert K, Wiggs, Ned T, Dasilva, Marcelo C, McCoach, Robert M, Pae, Walter E, Baer, Larry D, Hamilton, Lindy J, Hummer, Gregory J, Kapp, Christopher J, Williams, Dennis R
Format: Article
Language:English
Subjects:
Adult
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - surgery
Aortic Aneurysm - complications
Aortic Aneurysm - surgery
Blood Vessel Prosthesis Implantation
Cardiopulmonary Bypass - instrumentation
Cerebrovascular Circulation
Cocaine-Related Disorders - complications
Equipment Design
Female
Heart Arrest, Induced
Heart Septal Defects, Atrial - complications
Heart Septal Defects, Atrial - surgery
Humans
Hypertension - chemically induced
Hypertension - complications
Hypothermia, Induced
Infarction, Middle Cerebral Artery - complications
Reoperation
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Summary:Surgery for the repair of a type I aortic dissection presents several difficulties for the surgeon and the perfusionist. One must safely support the patient, while at the same time provide the surgeon with a bloodless field in which to operate. Often, this requires cessation of the circulation for varying amounts of time. Deep hypothermia allows for an extension of the arrest period, while other techniques - retrograde cerebral perfusion and antegrade cerebral perfusion - provide an additional degree of cerebral protection. Recently, we utilized these techniques concurrently on a 43-year-old female who presented for a reoperation for a type I aortic dissection. Combining these techniques allowed us to adequately support the patient during an anticipated lengthy period of circulatory arrest and insured a successful operation without any adverse cerebral or other organ dysfunction.
ISSN:0267-6591
1477-111X
DOI:10.1177/026765910001500211