1
|
Micovic S, Nezic D, Vukovic P, Jovanovic M, Lozuk B, Jagodic S, Djukanovic B. Concomitant reconstruction of arch vessels during repair of aortic dissection. Tex Heart Inst J 2014; 41:421-4. [PMID: 25120398 DOI: 10.14503/thij-13-3250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Surgery for acute aortic dissection is challenging, especially in cases of cerebral malperfusion. Should we perform only the aortic repair, or should we also reconstruct the arch vessels when they are severely affected by the disease process? Here we present a case of acute aortic dissection with multiple tears that involved the brachiocephalic artery and caused cerebral and right upper-extremity malperfusion. The patient successfully underwent complete replacement of the brachiocephalic artery and the aortic arch during deep hypothermic circulatory arrest, with antegrade cerebral protection. We have found this technique to be safe and reproducible for use in this group of patients.
Collapse
Affiliation(s)
- Slobodan Micovic
- Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
| | - Dusko Nezic
- Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
| | - Petar Vukovic
- Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
| | - Marko Jovanovic
- Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
| | - Branko Lozuk
- Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
| | - Sinisa Jagodic
- Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
| | - Bosko Djukanovic
- Departments of Cardiac Surgery (Drs. Djukanovic, Jovanovic, Micovic, Nezic, and Vukovic), Vascular Surgery (Dr. Lozuk), and Anesthesiology (Dr. Jagodic), Cardiovascular Institute Dedinje, 11000 Belgrade, Serbia
| |
Collapse
|