Use of Hypothermia and Cardiopulmonary Bypass in Resection of Aortic Arch Aneurysms

Abstract

Surgical correction of aortic arch aneurysms can be technically difficult and present hazards related to central nervous system and myocardial viability. Temporary circulatory arrest may be necessary, and in the age group in which most aneurysms are found, coronary and peripheral vascular disease increase the risk of ischemic damage. A patient is presented in whom hypothermia and cardiopulmonary bypass were utilized for resection of an aneurysm of the distal two-thirds of the aortic arch. Flow to the head through the right brachial and left common carotid arteries was regulated by monitoring pressure tracings from bilateral temporal artery catheters. Anoxic cardiac arrest for 70 minutes was well tolerated. No neurological deficit or cardiac dysfunction was evident postoperatively. Hypothermia with cardiopulmonary bypass is the approach of choice with aneurysms of the aortic arch. It affords the best protection for the central nervous system and myocardium.