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J. Thorac. Cardiovasc. Surg. · May 2021
Case ReportsPercutaneous cardioplegic arrest before repeat sternotomy in patients with retrosternal aortic aneurysm.
- Anand R Mehta, Bradley Hammond, Shinya Unai, Jose L Navia, Marc Gillinov, and Gosta B Pettersson.
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio.
- J. Thorac. Cardiovasc. Surg. 2021 May 1; 161 (5): 1724-1730.
ObjectiveRedo sternotomy in patients with arterial cardiac structures adherent to the sternum carries a risk of catastrophic bleeding. In some of those cases, particularly if they have undergone multiple previous operations, deep hypothermic circulatory arrest alone may not provide sufficient time for a controlled dissection.MethodsWe present a series of 6 cases at risk for exsanguination during sternal re-entry successfully reoperated using percutaneous cardioplegic cardiac arrest induced before completed sternal re-entry to avoid or minimize the hypothermic circulatory arrest time.ResultsAll patients survived their complex operations.ConclusionsPercutaneous cardioplegic arrest allows safer repeat sternotomy in patients with arterial cardiac structures adherent to the sternum.Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
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