A strategy for safe sternal reentry in patients with pseudoaneurysms of the ascending aorta using the PORT-ACCESS EndoCPB system.
Pseudoaneurysms of the ascending aorta developing after previous aortic or aortic valve surgery pose a high risk of exsanguination upon sternal reentry. In the past, femorofemoral bypass and hypothermic circulatory arrest before sternotomy was the preferred approach. Today, however, availability of the PORT-ACCESS EndoCPB system (Edwards Lifesciences, Irvine, CA, USA) allows for endovascular clamping and cardioplegia before sternotomy, avoiding circulatory arrest.
Reyes
Karl G
KG
Departments of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH 44195, USA.
Pettersson
Gosta B
GB
Mihaljevic
Tomislav
T
Roselli
Eric E
EE
D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D021721:Balloon Occlusion / Q000295:instrumentation*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003250:Constriction; D017548:Echocardiography, Transesophageal; D006324:Heart Arrest, Induced / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012086:Reoperation; D056346:Sternotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome