Abstract
Eight patients with aneurysms in the ascending aorta and the aortic arch underwent reconstructive surgery under deep hypothermia and circulatory arrest between Jan., 1988 and Jun., 1991. The patients consisted of 3 males and 5 females, ranging in age from 45 to 73 years (62.0±11.8, mean ±S.D.). Four patients were operated on in emergency. The lesions in 7 of 8 patients were Stanford type A dissecting aneurysms and the remaining one was a true aneurysm in the ascending aorta and the proximal aortic arch. The operation time, extracorporeal circulation time, and circulatory arrest time were 432.6±147.3, 191.9±66.1, and 31.0±10.8 (16 to 47) min, respectively. In all cases, the ascending aorta and the proximal aortic arch were replaced by an artificial graft through the median sternotomy approach. The brachiocephalic artery was reconstructed in 2 cases. The intraoperative blood loss was 4, 685±2, 943ml and the blood transfusion was 4, 659±2, 779ml. All patients awoke from 2 to 19hr after surgery and no complication in the central nervous system was observed. The postoperative complications which were detected in 3 patients consisted of drug induced renal dysfunction in 1 case, sinus arrhythmia in another, and mild hepatic dysfunction in the last case. There were neither operative deaths nor late deaths during the follow up period which ranged from 1 month to 42 months. Deep hypothermia and circulatory arrest should be regarded as a good circulatory support technique in reconstrutive surgery of the ascending aorta and the proximal aortic arch.
