Dataset Information

Mini-access open arch repair.

ABSTRACT:

Background

The use of minimally invasive approaches is scarce in open aortic arch repair because of its perceived high operative risk and technical difficulty.

Methods

This study enrolled 59 consecutive patients (aged 58.2±13.2 years) undergoing elective arch replacement either through upper hemi-sternotomy (n=58) or mini-thoracotomy (n=1) between 2015 and 2020. Of these, 44 underwent hemiarch replacement and 15 underwent total arch replacement. Moderate hypothermic circulatory arrest was used for all patients while antegrade cerebral perfusion was selectively used for total arch repair. For more efficient distal aortic anastomosis in limited spaces, inverted graft anastomosis was utilized whenever possible.

Results

Hemi-sternotomy involved upper sternal separation down to the second, third, and fourth intercostal spaces in 1 (1.7%), 30 (50.8%), and 27 (45.8%) patients, respectively. Concomitant cardiac procedures included root replacement in 19 patients (32.2%) and aortic valve replacement in 21 patients (35.6%). Circulatory arrest, cardiac ischemic, cardiopulmonary bypass, and total procedural times were 8.9±3.4, 91.1±31.1, 114.6±46.2, and 250.3±79.5 min, respectively for total arch repair, and 25.0±12.1, 72.3±16.6, 106.0±16.9, and 249.1±41.7 min, respectively for hemiarch repair. Conversion to full-sternotomy was required in 1 patient (1.7%) due to bleeding. There was one case of mortality (1.7%) attributable to low-cardiac output syndrome following hemiarch repair concomitantly with Bentall procedure. Major complications included requirement for mechanical support in 1 (1.7%), temporary neurologic deficit in 1 (1.7%), newly initiated dialysis in 3 (5.1%), and re-exploration due to bleeding in 2 (3.4%).

Conclusions

Mini-access open arch repair is technically feasible and achieved excellent early outcomes.

SUBMITTER: Kim SA

PROVIDER: S-EPMC8107538 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Publications

Mini-access open arch repair.

Kim Shi A SA Pyo Won Kyung WK Ok You Jung YJ Kim Ho Jin HJ Kim Joon Bum JB

Journal of thoracic disease 20210401 4

<h4>Background</h4>The use of minimally invasive approaches is scarce in open aortic arch repair because of its perceived high operative risk and technical difficulty.<h4>Methods</h4>This study enrolled 59 consecutive patients (aged 58.2±13.2 years) undergoing elective arch replacement either through upper hemi-sternotomy (n=58) or mini-thoracotomy (n=1) between 2015 and 2020. Of these, 44 underwent hemiarch replacement and 15 underwent total arch replacement. Moderate hypothermic circulatory ar ...[more]

PMID: 34012574

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Dataset Information

Mini-access open arch repair.

Background

Methods

Results

Conclusions

Publications

Mini-access open arch repair.

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