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

"Branch-first" continuous perfusion aortic arch replacement and its role in intra-operative cerebral protection.

Outcomes of Aortic Arch Replacement Performed Without Circulatory Arrest or Deep Hypothermia.

BACKGROUND Aortic arch replacement using standard techniques, including deep hypothermic circulatory arrest and selective antegrade cerebral perfusion, is still associated with significant mortality and cerebral morbidity. We have previously described the "branch-first" technique that avoids circulatory arrest or profound hypothermia with excellent outcomes. We now describe our clinical experie...

Technical aspects of total aortic repair in the surgical management of acute type A aortic dissection.

Traditional surgical techniques for the management of acute type A aortic dissection (ATAAD) focus on open distal anastomosis with or without hemiarch replacement under a period of deep hypothermic circulatory arrest. This is associated with high rates of false lumen (FL) patency, which exposes the patient to the risk of ongoing end-organ malperfusion and to the formation of complex arch and th...

Branch-first aortic arch replacement with no circulatory arrest or deep hypothermia.

BACKGROUND For aortic arch surgery, the potential risks of deep hypothermic circulatory arrest with or without antegrade cerebral perfusion have been widely documented. We hereby describe our early experience with a "branch-first continuous perfusion" technique that, by avoiding deep hypothermia and circulatory arrest, has the potential to reduce morbidity and mortality. METHODS Arterial perf...

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...