Aortic arch reconstruction using a trifurcated graft.
Cerebral protection and prevention of atheroembolism remain challenges in aortic arch reconstruction. To reduce neurologic complications, we developed a "no-touch" technique in which a trifurcated graft is anastomosed to the arch vessels during hypothermic circulatory arrest, reducing the risk of embolization while minimizing cerebral ischemia by permitting antegrade cerebral perfusion as arch reconstruction is completed.
Spielvogel
David
D
Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, New York 10029, USA. david.spielvogel@msnyuhealth.org
Mathur
Manu N
MN
Lansman
Steven L
SL
Griepp
Randall B
RB
D000714:Anastomosis, Surgical; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002545:Brain Ischemia / Q000517:prevention & control*; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D020766:Intracranial Embolism / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000517:prevention & control*; D011474:Prosthesis Design; D013536:Suture Techniques