ICVTS on-line discussion A
Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul 34732, Turkey
Long-term outcomes after repaired acute type A aortic dissections
The authors [1] said that cardiopulmonary bypass was established by median sternotomy after retrograde femoral cannulation in the first sentence of the surgical procedure, but in the same section they used antegrade cerebral perfusion in some cases. I do not understand exactly how they performed antegrade cerebral perfusion: via the subclavian artery or the innominate artery. Also, they should explain what they used for antegrade cerebral perfusion.
Recently, so many aortic surgeons have been using open distal repair. If aortic regurgitation is less than 2+, we can use open distal anastomosis easily without cardiac venting problems. If aortic regurgitation is more than 2+, we have to use aortic cross-clamp and we can repair proximal anastomosis first.
References
Gariboldi V, Grisoli D, Kerbaul F, Giorgi R, Riberi A, Metras D, Mesana TG, Collart F. Long-term outcomes after repaired acute type A aortic dissections. Interact CardioVasc Thorac Surg doi:10.1510/icvts.2006.136606 [UPDATE!].(Mehmet Ates)
Long-term outcomes after repaired acute type A aortic dissections
The authors [1] said that cardiopulmonary bypass was established by median sternotomy after retrograde femoral cannulation in the first sentence of the surgical procedure, but in the same section they used antegrade cerebral perfusion in some cases. I do not understand exactly how they performed antegrade cerebral perfusion: via the subclavian artery or the innominate artery. Also, they should explain what they used for antegrade cerebral perfusion.
Recently, so many aortic surgeons have been using open distal repair. If aortic regurgitation is less than 2+, we can use open distal anastomosis easily without cardiac venting problems. If aortic regurgitation is more than 2+, we have to use aortic cross-clamp and we can repair proximal anastomosis first.
References
Gariboldi V, Grisoli D, Kerbaul F, Giorgi R, Riberi A, Metras D, Mesana TG, Collart F. Long-term outcomes after repaired acute type A aortic dissections. Interact CardioVasc Thorac Surg doi:10.1510/icvts.2006.136606 [UPDATE!].(Mehmet Ates)