Sun’s procedure | Our operation | |
---|---|---|
Similarities | operative Indications surgical materials anesthesia cannulation of the vena cava repair of aortic root | |
Differences | ||
Incision | median sternotomy right infra-clavicular | median sternotomy left infra-clavicular inferior inguinal ligament |
Artery perfusion | right axillary artery left common carotid artery | femoral artery, innominate artery, left common carotid artery left subclavian artery |
Left subclavian artery | transected, end-to-end anastomosed to the arched branch of the 4-branched graft | ligated, A 8 mm graft was end-to-side anastomosed to the left subclavian artery and the other end of this graft was tunneled via the second intercostal space into the ediastinum connected to the arched branch of the 4-branched graft |
Cerebral perfusion | selective | bilateral |
Temperature of circulatory arrest | deep hypothermia | 30 °C |
Time of circulatory arrest | more than 20 min | less than 1 min |
Lower-body perfusion when anastomosis was performed between the proximal stent graft and the distal 4-branched graft | No | the aortic arch and stent graft were cross-clamped, lower-body perfusion was restored by the femoral artery |
Sit of anastomosis between the proximal stent graft and the distal 4-branched graft | descending aorta distally to the origin of the native left subclavian artery | aortic arch between the innominate artery and the left common carotid artery |