Repair of the aortic arch with left unilateral selective cerebral perfusion

A 67-year-old woman who presented with chest and back pain was diagnosed with an aneurysm of the ascending aorta. Coronary angiography and aortography were performed via the right brachial artery, which was complicated by axillary artery dissection. At surgery, despite our clinical experience of usi...

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Bibliographic Details
Published in:Perfusion 2004-01, Vol.19 (1), p.77-79
Main Authors: Akgul, Ahmet, Ozatik, Mehmet Ali, Kucuker, Seref Alp, Bahar, Ilknur, Tasdemir, Oguz
Format: Article
Language:English
Subjects:
Aged
Aneurysm, Dissecting - diagnostic imaging
Aneurysm, Dissecting - surgery
Aorta
Aorta, Thoracic - surgery
Aortic Aneurysm - diagnostic imaging
Aortic Aneurysm - surgery
Cardiopulmonary Bypass
Carotid Arteries - physiopathology
Cerebrovascular Circulation
Cineangiography
Constriction
Female
Humans
Subclavian Artery - physiopathology
Tomography, X-Ray Computed
Treatment Outcome
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Summary:A 67-year-old woman who presented with chest and back pain was diagnosed with an aneurysm of the ascending aorta. Coronary angiography and aortography were performed via the right brachial artery, which was complicated by axillary artery dissection. At surgery, despite our clinical experience of using the right upper brachial artery for arterial cannulation, right femoral artery cannulation was performed to establish cardio-pulmonary bypass (CPB) as the dissection was extending to the brachiocephalic artery. The aortic crossclamp was placed on the arch of the aorta just after the origin of the brachiocephalic artery so that cerebral perfusion was performed via the left common carotid and left vertebral and basilar arteries through the left subclavian artery. No neurologic event was observed during the intensive care unit stay and follow-up period. To the best of our knowledge, the literature contains no other report of the use of only the left carotid and subclavian arteries to perfuse cerebral structures during CPB.
ISSN:0267-6591
1477-111X
DOI:10.1191/0267659104pf706cr