title: Reoperation for a type I aortic dissection: case report.
abstract: Surgery for the repair of a type I aortic dissection presents several difficulties for the surgeon and the perfusionist. One must safely support the patient, while at the same time provide the surgeon with a bloodless field in which to operate. Often, this requires cessation of the circulation for varying amounts of time. Deep hypothermia allows for an extension of the arrest period, while other techniques-- retrograde cerebral perfusion and antegrade cerebral perfusion--provide an additional degree of cerebral protection. Recently, we utilized these techniques concurrently on a 43-year-old female who presented for a reoperation for a type I aortic dissection. Combining these techniques allowed us to adequately support the patient during an anticipated lengthy period of circulatory arrest and insured a successful operation without any adverse cerebral or other organ dysfunction.
authors.affiliation: The Milton S Hershey Medical Center, Penn State Geisinger Health System, Hershey, Pennsylvania 17033, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Wise
authors.forename: N T
authors.initials: NT
authors.lastname: Wiggs
authors.forename: M C
authors.initials: MC
authors.lastname: Dasilva
authors.forename: R M
authors.initials: RM
authors.lastname: McCoach
authors.forename: W E
authors.initials: WE
authors.lastname: Pae
authors.forename: L D
authors.initials: LD
authors.lastname: Baer
authors.forename: L J
authors.initials: LJ
authors.lastname: Hamilton
authors.forename: G J
authors.initials: GJ
authors.lastname: Hummer
authors.forename: C J
authors.initials: CJ
authors.lastname: Kapp
authors.forename: D R
authors.initials: DR
authors.lastname: Williams
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D002560:Cerebrovascular Circulation; D019970:Cocaine-Related Disorders / Q000150:complications; D004867:Equipment Design; D005260:Female; D006324:Heart Arrest, Induced; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000150:complications; D007036:Hypothermia, Induced; D020244:Infarction, Middle Cerebral Artery / Q000150:complications; D012086:Reoperation