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Eur J Cardiothorac Surg 2002;21:89-91
© 2002 Elsevier Science NL

How-to-do-it

Aortic arch replacement using a four-branched aortic arch graft

Clinic for Cardiovascular Surgery, University Hospital, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland

Received 11 September 2001; received in revised form 11 October 2001; accepted 14 October 2001.

* Corresponding author. Tel.: +41-22-372-7630; fax: +41-22-372-7634
e-mail: marek.bednarkiewicz{at}hcuge.ch

Surgical repair for aortic arch aneurysms is associated with considerable mortality and morbidity. Adequate brain protection is essential. Experience of aortic arch repair in six patients using a four-branched arch graft is described. There were two emergency and three reoperations. One patient had ruptured aneurysm. Hypothermic cardiopulmonary bypass (18–22°C) was employed. A four-branched polymer albumin-coated arch graft was used. The fourth branch of the graft was used for secondary arterial cannulation to ensure continuous brain circulation. One hospital death occurred. No permanent neurological event occurred. The four-branched arch graft facilitates fashioning arch branch anastomoses and provides better brain protection.

Key Words: Transverse aortic arch replacement • Aortic arch aneurysm • Brain protection • Subclavian artery • Circulatory arrest • Aortic arch graft • Mortality • Morbidity

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