title: Modified trifurcated graft in acute type A aortic dissection with the least brain ischemic time.
abstract: Cerebral ischemia, bleeding, and inadequate myocardial protection are the major concerns in doing aortic arch operation. The trifurcated graft technique as described by Spielvogel and associates was a useful technique in reducing the risk of postoperative neurologic complications. However, the cerebral ischemic time may be still too long in inexperienced hands. We recently encountered 3 patients of acute type A aortic dissection who needed aortic arch replacement. By modifying the procedure of the trifurcated graft technique and using a reversed sleeve graft technique, we greatly reduced the duration of cerebral and myocardial ischemia and made bleeding a minor problem.
authors: Division of Cardiovascular Surgery, Chi-Mei Hospital, Yungkang City, Taiwan. eadwine_chen@yahoo.com.tw
authors: Chien-Chang
authors: CC
authors: Chen
authors: Shih-Rong
authors: SR
authors: Hsieh
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D002545:Brain Ischemia / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass / Q000379:methods; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D011474:Prosthesis Design; D011859:Radiography; D018570:Risk Assessment; D012494:Sampling Studies; D013997:Time Factors; D016896:Treatment Outcome