Complications associated with clamping the aorta between the left common carotid artery and left subclavian artery

Toshihiko Ueda, Hideyuki Shimizu, Katsumi Moro, Hankei Shin, Ryouhei Yozu, Ichiro Kashima, Shiaki Kawada

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. Hypothermic circulatory arrest using a left thoracotomy has recently been recommended for repair of distal arch lesions to prevent the atheroembolism that often results from clamp injury. The recommendation holds even for cases in which aortic crossclamping between the left common carotid artery and left subclavian artery is possible. Methods. Over the last 16 years, 69 patients underwent repair of the distal arch or descending thoracic aorta using distal perfusion with the proximal aortic clamp placed between the left common carotid and left subclavian artery. The average age of the patients was 61 ± 12 years; 18 of them (26%) were older than 70 years. Forty-four patients (64%) had atherosclerotic true aneurysms. Results. The surgical procedures used included patch closure of saccular aneurysms in 20 patients (29%) and graft replacement in 47 (71%). The left subclavian artery was reattached in 7 patients (10%). Although there were 3 hospital deaths (4%), no cerebral complications occurred aside from temporary neurologic dysfunction in 4 patients (6%). Conclusions. An acceptably low incidence of cerebral complications is associated with cross-clamping the aorta between the left common carotid artery and left subclavian artery. (C) 2000 by The Society of Thoracic Surgeons.

Original languageEnglish
Pages (from-to)558-561
Number of pages4
JournalAnnals of Thoracic Surgery
Volume70
Issue number2
DOIs
Publication statusPublished - 2000

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Subclavian Artery
Common Carotid Artery
Constriction
Aorta
Thoracic Aorta
Aneurysm
Cholesterol Embolism
Thoracotomy
Neurologic Manifestations
Perfusion
Transplants
Incidence
Wounds and Injuries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Complications associated with clamping the aorta between the left common carotid artery and left subclavian artery. / Ueda, Toshihiko; Shimizu, Hideyuki; Moro, Katsumi; Shin, Hankei; Yozu, Ryouhei; Kashima, Ichiro; Kawada, Shiaki.

In: Annals of Thoracic Surgery, Vol. 70, No. 2, 2000, p. 558-561.

Research output: Contribution to journalArticle

Ueda, Toshihiko ; Shimizu, Hideyuki ; Moro, Katsumi ; Shin, Hankei ; Yozu, Ryouhei ; Kashima, Ichiro ; Kawada, Shiaki. / Complications associated with clamping the aorta between the left common carotid artery and left subclavian artery. In: Annals of Thoracic Surgery. 2000 ; Vol. 70, No. 2. pp. 558-561.
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AU - Shimizu, Hideyuki

AU - Moro, Katsumi

AU - Shin, Hankei

AU - Yozu, Ryouhei

AU - Kashima, Ichiro

AU - Kawada, Shiaki

PY - 2000

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N2 - Background. Hypothermic circulatory arrest using a left thoracotomy has recently been recommended for repair of distal arch lesions to prevent the atheroembolism that often results from clamp injury. The recommendation holds even for cases in which aortic crossclamping between the left common carotid artery and left subclavian artery is possible. Methods. Over the last 16 years, 69 patients underwent repair of the distal arch or descending thoracic aorta using distal perfusion with the proximal aortic clamp placed between the left common carotid and left subclavian artery. The average age of the patients was 61 ± 12 years; 18 of them (26%) were older than 70 years. Forty-four patients (64%) had atherosclerotic true aneurysms. Results. The surgical procedures used included patch closure of saccular aneurysms in 20 patients (29%) and graft replacement in 47 (71%). The left subclavian artery was reattached in 7 patients (10%). Although there were 3 hospital deaths (4%), no cerebral complications occurred aside from temporary neurologic dysfunction in 4 patients (6%). Conclusions. An acceptably low incidence of cerebral complications is associated with cross-clamping the aorta between the left common carotid artery and left subclavian artery. (C) 2000 by The Society of Thoracic Surgeons.

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