title: Transapical aortic cannulation via left lateral thoracotomy for descending thoracic and thoracoabdominal aortic surgery.
abstract: Two patients underwent surgery for a chronic type B dissection using a total cardiopulmonary bypass (CPB) with transapical arterial cannulation. At surgery, a total CPB was established by cannulating the left femoral artery and the ascending aorta via the ventricular apex. The patients were cooled to 30 degrees C. The proximal anastomosis was done after cross-clamping the aortic arch between the left carotid artery and the left subclavian artery in both cases. In the first case, the entire descending thoracic aorta was replaced, and two pairs of intercostal arteries were reconstructed. The other patient underwent replacement of the proximal descending thoracic aorta. Neither patient experienced any complications. Transapical aortic cannulation is a useful option during descending thoracic and thoracoabdominal aortic surgery. It can provide more stable circulation during the cross-clamping, more gentle manipulation of the aorta by nonpulsatile flow, and more liberty in temperature control.
authors.affiliation: Japanese Red Cross Nagoya First Hospital, Michishita-cho, Nakamura-ku, Nagoya, Aichi, Japan. tomonobu_abe@chukyo-hosp.jp
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Abe
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ito
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Sunada
authors.forename: Tomo
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Akemi
authors.initials: A
authors.lastname: Kawamura
authors.forename: Koji
authors.initials: K
authors.lastname: Yamana
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D002404:Catheterization / Q000379:methods*; D002908:Chronic Disease; D003250:Constriction; D006439:Hemodynamics; D006801:Humans; D008297:Male; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome