Onlay patch for complete intercostal artery preservation during thoracic and thoracoabdominal aortic aneurysm repair

Abelardo DeAnda, Jonathan M. Philpott, Vigneshwar Kasirajan

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Replacement of the thoracic aorta is associated with a potential for interruption of the blood supply to the spinal cord leading to paralysis. Techniques have been proposed to ameliorate this risk, including reimplantation of the intercostal arteries. We present a technique to simplify this approach. Methods: In patients with extensive aneurismal disease, a standard approach to the thoracic aorta via a left thoracotomy is performed. The patient is placed on full cardiopulmonary bypass with moderate hypothermia. The proximal anastomosis is performed unclamped with circulatory arrest. After completing the proximal and distal anastomosis separately, an onlay patch of Dacron is created and placed along the entire back wall of the aorta to cover all of the intercostal arteries. A side-to-side anastomosis between the patch and the distal graft is then performed and subsequently the anastomosis tested by retrograde flow. Results: The technique allows direct inspection of all suture lines, tested to an adequate pressure, so that postoperative bleeding is minimal. Conclusion: Techniques to lessen the risk of paraplegia associated with aortic surgery include reimplantation of the intercostal arteries. This technique allows each suture line to be tested and easily visually inspected prior to closure of the chest.

Original languageEnglish (US)
Pages (from-to)578-581
Number of pages4
JournalJournal of Cardiac Surgery
Volume20
Issue number6
DOIs
StatePublished - Nov 2005
Externally publishedYes

Fingerprint

Thoracic Aortic Aneurysm
Inlays
Arteries
Replantation
Thoracic Aorta
Sutures
Polyethylene Terephthalates
Paraplegia
Thoracotomy
Hypothermia
Cardiopulmonary Bypass
Paralysis
Aorta
Spinal Cord
Thorax
Hemorrhage
Transplants
Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Onlay patch for complete intercostal artery preservation during thoracic and thoracoabdominal aortic aneurysm repair. / DeAnda, Abelardo; Philpott, Jonathan M.; Kasirajan, Vigneshwar.

In: Journal of Cardiac Surgery, Vol. 20, No. 6, 11.2005, p. 578-581.

Research output: Contribution to journalArticle

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