Surgical Experience of Ascending Aorta and Aortic Valve Replacement in Patient with Calcified Aorta
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Á¤¼ö·Ã(Chung Su-Ryeun) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
¹ÚÇ¥¿ø(Park Pyo-Won) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
Ãֹμ®(Choi Min-Suk) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
Á¶¼ºÈ£(Cho Seong-Ho) - Kosin University Gospel Hospital Department of Thoracic and Cardiovascular Surgery
¼º±âÀÍ(Sung Ki-Ick) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
ÀÌ¿µÅ¹(Lee Young-Tak) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
Á¤ÀçÇÑ(Jeong Jae-Han) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
Abstract
Background: The conventional method of aortic cross-clamping is very difficult and increases the risk of cerebral infarct due to embolism of the calcified aorta in these patients. Accordingly, we analyzed our experience with 11 cases of ascending aorta and aortic valve replacement with hypothermic circulatory arrest.
Materials and Methods: From January 2002 to December 2009, 11 patients had ascending aorta and aortic valve replacement with hypothermic arrest at our hospital. We performed a retrospective study.
Results: There were 5 males and 6 females, with a mean age of 68 years (range, 44 to 82 years). Eight patients had aortic stenosis, and 3 patients had aortic regurgitation. An aortic cannula was inserted into the right axillary artery in 3 patients and ascending aorta in 6 patients. Two patients with aortic regurgitation had a remote access perfusion catheter inserted though the right femoral artery. The mean cardiopulmonary bypass time was 180 minutes (range, 110 to 306 minutes) and mean hypothermic circulatory arrest time was 30 minutes (range, 20 to 48 minutes). The mean rectal temperature during hypothermic circulatory arrest was 21oC (range, 19oC to 23¡ÆC). No patient had any new onset of cerebral infarct or cardiovascular accident after surgery. There was no hospital mortality. Early complications occurred in 1 patient who needed reoperation due to postoperative bleeding. Late complications occurred in 1 patient who underwent a Bentall operation due to prosthetic valve endocarditis. The mean follow-up duration was 32 months (range, 1 month to 8 years) and 1 patient died suddenly due to unknown causes after 5 years.
Conclusion: Patients with a calcified aorta can be safely treated with a technique based on aorta and aortic valve replacement under hypothermic circulatory arrest.
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Aortic valve replacement, Calcified aorta, Total circulatory arrest, induced
KMID :
0364020120450010024
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À¯È¿¼º°á°ú(Recomendation)
Ascending aorta and aortic valve replacement under hypothermic circulatory arrest without the aortic cross clamping technique showed no cerebrovascular complications after operation in calcified ascending aorta patients, specifically in an elderly group.