title: Endovascular Aortic Arch Repair with Mini-Cardiopulmonary Bypass to Prevent Stroke.
abstract: Debranching thoracic endovascular aortic repair for aortic arch pathology is an important alternative to total arch replacement. However, the problem of intraoperative stroke due to atherosclerotic changes in the aorta remains. We apply our minimally invasive mini-cardiopulmonary bypass system to prevent intraoperative stroke during the endovascular procedure. Once debranching from the right axillary artery to the left common carotid and the left axillary artery is constructed; only the brachiocephalic artery is a pathway to the brain. After mini-cardiopulmonary bypass using the debranching graft is established, all cerebral perfusions are not only maintained, but retrograde blood flow from the brachiocephalic artery to the aortic arch is secured. All endovascular procedures can be performed under this situation. Our technique could be effective for preventing intraoperative stroke for endovascular repair with the debranching method for aortic arch pathology.
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ryomoto
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Hiroe
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kajiyama
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Mitsuno
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yamamura
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukui
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. Electronic address: y-miyamo@hyo-med.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001366:Axillary Artery / Q000503:physiopathology / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D017536:Carotid Artery, Common / Q000503:physiopathology / Q000601:surgery; D002560:Cerebrovascular Circulation; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D020521:Stroke / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome