title: Novel methods of myocardial protection and de-airing for complex descending aortic aneurysm surgery.
abstract: A 64-year-old male who had previously undergone an aortic valve replacement and replacement of the ascending aorta presented with an 8 cm descending aortic aneurysm. A left thoracotomy was required to allow replacement of the aorta. However, due to longitudinal as well as transverse expansion, visualisation of the aortic arch was compromised, preventing cross-clamping of the proximal aorta. Cardiopulmonary bypass and deep hypothermic circulatory arrest were, therefore, required. An unusual method of cardioplegia delivery was used for myocardial protection, utilising a Foley catheter under direct vision as an alternative to more expensive percutaneous peripheral endoclamp devices. We also describe an unusual cardiopulmonary bypass circuit, with the dual use of a left atrial cannula for venting and also for re-establishing perfusion during de-airing.
authors.affiliation: Department of Clinical Perfusion Science, Trent Cardiac Centre, City Hospital, Nottingham, UK.
authors.forename: L Y
authors.initials: LY
authors.lastname: White
authors.forename: A
authors.initials: A
authors.lastname: Rowe
authors.forename: J
authors.initials: J
authors.lastname: Campbell
authors.forename: I M
authors.initials: IM
authors.lastname: Mitchell
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*; D016896:Treatment Outcome