Journal of cardiac surgery
-
We currently routinely use profound hypothermic circulatory arrest (PHCA) with retrograde cerebral perfusion (RCP) during repair of proximal aortic dissection and aneurysms involving the transverse aortic arch. Experimental data regarding the efficacy of RCP are conflicting. We retrospectively reviewed our experience with proximal aortic surgery to compare the results of PHCA performed with and without RCP. ⋯ Patients who had RCP during PHCA had lower mortality and stroke rates than those who did not. Although the higher prevalence of cerebrovascular disease, diabetes, and dissection in the latter group may have contributed to these differences, the clinical results confirm the safety and potential benefits of RCP, further supporting its use during proximal aortic surgery requiring circulatory arrest.
-
Until recently the surgical treatment of aneurysms of the aortic root in patients with the Marfan syndrome consisted of composite replacement of the aortic valve and ascending aorta. At the present, almost one-half of these patients can have reconstruction of the aortic root with preservation of the aortic valve. The mitral valve can also be frequently preserved. ⋯ Although the number of patients in each group is small and the follow-up relatively short, aortic valve-sparing operations have given gratifying results and may prove superior to valve replacement in patients with the Marfan syndrome.