Total arch replacement: Technical pearls

Fast – Track Total Arch Replacement

Open aortic arch replacement: a technical odyssey.

Open repair of aneurysms and dissections involving the aortic arch has traditionally been associated with high rates of morbidity and mortality, primarily because of the complications related to the need to interrupt normal blood flow to the cerebral circulation. Over the past several years, our approach to these operations has gradually changed largely through the introduction of various techn...

Total endograft replacement of aortic arch.

Total endovascular replacement of the aortic arch is a complex procedure that is often favoured when the pathology anatomy precludes a standard median sternotomy. Here we present the case of endograft repair in a 79 year old male with 6.5 cm arch aneurysm and 5.4 cm descending thoracoabdominal aneurysm. Following bilateral carotid-subclavian bypasses, a long 7 Fr sheath was advanced into the de...

Continuous perfusion "Branch-first" aortic arch replacement: a technical perspective.

The following video, along with the in-depth perspective article published elsewhere in this issue, aims to take you through the significant steps and the theoretical aspects of aortic arch replacement using the “Branch-first” continuous perfusion technique (Video 1). In essence the procedure consists of 5 major steps: (I) Establishment of cardiopulmonary bypass using femoral inflow and moderat...

Outcome of total arch replacement with coronary artery bypass grafting.

OBJECTIVES There are few reports on the outcome of total arch replacement (TAR) with concomitant coronary artery bypass grafting (CABG); the present study was aimed at analysing outcomes after TAR with CABG at our institute. METHODS Between January 2002 and December 2012, 123 consecutive patients underwent elective TAR with or without CABG. The patients were divided into two groups: 46 who ha...