OBJECTIVE Replacement of the entire descending aorta or of the thoracoabdominal aorta still has a significant risk for postoperative paraplegia. Surgical strategies using a deep hypothermia to protect the spinal cord or viscera are discussed. METHODS From April 1994, 25 patients underwent graft replacement of the entire descending aorta (13 patients) or thoracoabdominal aorta (12 patients) us...

The hemodynamic consequences and myocardial blood flow alterations associated with cross-clamping of the thoracic aorta were studied during pentobarbital (control), halothane (1 MAC), and isoflurane (1 MAC) anesthesia in dogs with a critical stenosis of the left circumflex coronary artery. Aortic clamping at the level of the diaphragm resulted in significant and equivalent increases in mean aor...

Reports have shown the antioxidant, hypotensive, hypolipidemic and vasodilatory effects of grape (Vitis vinifera L.) seed extract. We have recently shown the relaxatory effect of grape leaf extract on rat uterus and reduction of frog heart rate and contractility. The aim of the present study was to investigate the relaxant effect of Vitis vinifera leaf hydroalcoholic extract (VLHE) on rat thora...

reports have shown the antioxidant, hypotensive, hypolipidemic and vasodilatory effects of grape (vitis vinifera l.) seed extract. we have recently shown the relaxatory effect of grape leaf extract on rat uterus and reduction of frog heart rate and contractility. the aim of the present study was to investigate the relaxant effect of vitis vinifera leaf hydroalcoholic extract (vlhe) on rat thora...

Many recent technical advances have enhanced the safety of open surgery of the descending thoracic aorta. Previous to the refinement of these adjuncts and techniques, surgeons such as Stanley Crawford showed that simple aortic cross-clamping with expeditious surgery produced the best results. In Crawford’s era of “clamp and go”, time limitations pressured surgeons to perform anastomoses rapidly...

The recently published ASCERT [1], SYNTAX [2] and FREEDOM [3] trials have demonstrated a clear benefit for coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) in the treatment of multivessel coronary disease that increases over time [4]. The main criticism of CABG in the SYNTAX trial was the higher 30-day stroke rate when compared with PCI (2.2 vs 0.6%). However...

p s {}:^, CLINICAL STUDY Eighty-six consecutive prosthetic valve replacements were studied. Cardiopulmonary bypass was established in each with disc or bubble oxygenators, reducing the temperature of the patient to 300 C. The aorta was clamped in each case, coronary perfusion being carried out for 3 minutes at the end of each 10-minute interval by release of the aortic clamp, except when the ao...

Paraplegia is a tragic complication of surgery of the descending aorta. It is unpredictable and occurs with a similar incidence with or without distal circulatory support. Hypotension, prolonged aortic cross clamp time, and ligation of intercostal arteries have been considered causative factors. Recent experience with ten consecutive patients undergoing descending aortic surgery without shunts ...

A sutureless ringed intraluminal graft has been used as a substitute for the diseased aorta with the advantage of decreasing the aortic cross-clamp time and blood loss. Concerns remain about implications of anecdotal accounts of late complications with this graft. We report on the experience of a 68-year-old man, successfully treated for type B aortic dissection using the sutureless technique, ...