Retrograde cerebral perfusion through antero-axillary thoracotomy in the aortic arch surgery.
OBJECTIVE
We have recently found that left antero-axillary thoracotomy provides an ideal view of aortic arch and makes the direct cannulation to superior vena cava possible for retrograde cerebral perfusion during circulatory arrest.


METHODS
Twelve patients with distal aortic arch aneurysm or aortic dissection underwent the repair of aortic arch through this approach. Mean duration of retrograde cerebral perfusion was 41 min.


RESULTS
Two hospital deaths occurred due to respiratory failure and stroke. The remaining patients survived without any neurological deficits.


CONCLUSIONS
Antero-axillary thoracotomy may be an ideal approach which combines the advantages of median sternotomy and postero-lateral thoracotomy.
Sasaguri
S
S
Department of Thoracic and Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
Yamamoto
S
S
Fukuda
T
T
Hosoda
Y
Y
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D001921:Brain / Q000098:blood supply*; D002545:Brain Ischemia / Q000209:etiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate; D013908:Thoracotomy / Q000379:methods*