Niranjan Hiremath , Gopal Bhatnagar , Khubaib Mapara , Houssam Younes , Woosup Michael Park
{"title":"改良分支先行胸腹主动脉瘤开放性修复术技术描述","authors":"Niranjan Hiremath , Gopal Bhatnagar , Khubaib Mapara , Houssam Younes , Woosup Michael Park","doi":"10.1053/j.optechstcvs.2022.08.004","DOIUrl":null,"url":null,"abstract":"<div><p><span>The current conventional open TAAA repairs are performed by select centers around the world with good outcomes. However, lesser experienced centers often encounter difficulties in replicating similar results of open TAAA surgeries. The modified branch-first open repair of TAAA has shown to be effective in minimizing visceral and renal complications by providing continuous visceral blood flow<span> throughout the procedure. By debranching the visceral vessels first, we can perform this complex aortic procedure in a more controlled manner as compared to the traditional clamp and sew technique which requires speed, precision and experience. The entire repair can be performed on beating heart by deriving native blood flow via a closed circuit or a modification of the left heart bypass and continuously perfusing the </span></span>abdominal viscera<span>, thus avoiding cardiopulmonary bypass<span> or deep hypothermic circulatory arrest which helps minimize bleeding and overall morbidity associated with extensive TAA surgeries. Adequate pre-operative planning is imperative to prevent spinal cord complications and intra-operative emergencies.</span></span></p></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Modified Branch-first Open Repair of Thoracoabdominal Aortic Aneurysm- A Technical Description\",\"authors\":\"Niranjan Hiremath , Gopal Bhatnagar , Khubaib Mapara , Houssam Younes , Woosup Michael Park\",\"doi\":\"10.1053/j.optechstcvs.2022.08.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p><span>The current conventional open TAAA repairs are performed by select centers around the world with good outcomes. However, lesser experienced centers often encounter difficulties in replicating similar results of open TAAA surgeries. The modified branch-first open repair of TAAA has shown to be effective in minimizing visceral and renal complications by providing continuous visceral blood flow<span> throughout the procedure. By debranching the visceral vessels first, we can perform this complex aortic procedure in a more controlled manner as compared to the traditional clamp and sew technique which requires speed, precision and experience. The entire repair can be performed on beating heart by deriving native blood flow via a closed circuit or a modification of the left heart bypass and continuously perfusing the </span></span>abdominal viscera<span>, thus avoiding cardiopulmonary bypass<span> or deep hypothermic circulatory arrest which helps minimize bleeding and overall morbidity associated with extensive TAA surgeries. Adequate pre-operative planning is imperative to prevent spinal cord complications and intra-operative emergencies.</span></span></p></div>\",\"PeriodicalId\":35965,\"journal\":{\"name\":\"Operative Techniques in Thoracic and Cardiovascular Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Operative Techniques in Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1522294222000940\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Techniques in Thoracic and Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1522294222000940","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Modified Branch-first Open Repair of Thoracoabdominal Aortic Aneurysm- A Technical Description
The current conventional open TAAA repairs are performed by select centers around the world with good outcomes. However, lesser experienced centers often encounter difficulties in replicating similar results of open TAAA surgeries. The modified branch-first open repair of TAAA has shown to be effective in minimizing visceral and renal complications by providing continuous visceral blood flow throughout the procedure. By debranching the visceral vessels first, we can perform this complex aortic procedure in a more controlled manner as compared to the traditional clamp and sew technique which requires speed, precision and experience. The entire repair can be performed on beating heart by deriving native blood flow via a closed circuit or a modification of the left heart bypass and continuously perfusing the abdominal viscera, thus avoiding cardiopulmonary bypass or deep hypothermic circulatory arrest which helps minimize bleeding and overall morbidity associated with extensive TAA surgeries. Adequate pre-operative planning is imperative to prevent spinal cord complications and intra-operative emergencies.
期刊介绍:
Operative Techniques in Thoracic and Cardiovascular Surgery provides richly illustrated articles on techniques in thoracic and cardiovascular surgery written by renowned surgeons. Each issue presents cardiothoracic topics in adult cardiac, congenital, and general thoracic surgery. Each specialty of interest to the thoracic and cardiovascular surgeon is explored through two different approaches to a specific surgical challenge. Each article is thoroughly illustrated with original line drawings, actual intraoperative photos, and supporting tables and graphs.