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Eur J Cardiothorac Surg 2001;20:1240-1242
© 2001 Elsevier Science NL

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Surgical strategy for repair of large pseudoaneurysms of the aortic isthmus

Division of Cardiothoracic Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA

Received 23 July 2001; received in revised form 3 September 2001; accepted 4 September 2001.

Corresponding author. Great Ormond Street Hospital for Children, Cardiothoracic Unit, Great Ormond Street, London WC1N 3JH, UK. Tel.: +44-020-74059200; fax: +44-020-7813-8262
e-mail: marcoriccimd{at}hotmail.com

Abstract

Resection of unusually large pseudoaneurysms of the aortic isthmus is complex, and involves various strategies of cardiopulmonary bypass (CPB), cerebral and spinal cord protection. We report on a patient with a giant pseudoaneurysm of the distal arch and proximal descending aorta, in whom cannulation of the femoral artery was unfeasible. Instead, the right axillary artery and the left femoral vein were cannulated. This technique allowed to perform a left anterolateral thoracotomy with the patient already on CPB and hypothermic, and to shorten the duration of hypothermic circulatory arrest.

Key Words: Descending thoracic aortic aneurysm, aortic isthmus, hypothermic circulatory arrest, cerebral protection, axillary artery

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