Carotid artery inflow in operations to correct aortic diseases (ascending, arch and descending)

摘要

OBJECTIVE: Femoral artery cannulation has been used as the preferred option in operations to correct ascending aorta and aortic arch aneurysms and dissections. The axillary artery is an alternative site for cannulation. We have used arterial inflow via the common carotid artery in nine patients. METHOD: Nine patients were operated on with ages ranging from 46 to 80 years (mean 62.1 ± 12.54), six were male. Four patients had true aneurysms, three had aortic dissections and two a combination of dissections and true aneurysms. Five patients had undergone previous cardiovascular operations. Deep hypothermia with circulation arrest was used in two patients and in seven, antegrade cerebral perfusion was used. RESULTS: All nine patients awoke from the operation without cerebral damage. Two patients died, one on the 7th postoperative day due to respiratory failure and the other one on the third postoperative day due to a rupture of a thoracoabdominal aortic aneurysm. CONCLUSION: The carotid artery can be a safe alternative of arterial inflow in operations to correct ascending aorta and aortic arch diseases. This strategy allows antegrade cerebral perfusion during the operation even during arch resection and reconstruction.