One-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest

Abstract

To summarize the experience in one-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest. From August 2003 to May 2005 38 patients with thoracoabdominal aortic disease, including severe extensive thoracoabdominal aorta of Crawford II type (n = 4), chronic Stanford type B dissecting aneurysm (n = 24), chronic Stanford type A dissecting aneurysm (n = 5), and Marfan's syndrome with chronic Stanford type B dissecting aneurysm (n = 5), 25 males and 13 females, aged 40 +/- 9 (22-58), underwent one-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest. Two patients died during the early post-operational period with a mortality of 5.26%. Four patients showed cerebral complications with an incidence of 10.5% and were cured after hydration therapy. Acute kidney dysfunction occurred in 2 patients and was cured by hemodialysis. With simplified operational procedure, one-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest significantly shortens the ischemic time of brain, spinal cord, and other major organs and has an excellent effect.