Transaxillary aortic endoclamping for ascending aortic pseudoaneurysm and dissected descending aorta. 2005

Daniele Maselli, and Francesco Musumeci
Department of Cardiac Surgery, Azienda Ospedaliera S. Camillo-Forlanini, Rome, Italy. dmaselli@tiscali.it

Patients presenting with pseudoaneurysm of the aortic root close to the sternum, severe aortic regurgitation, and chronic dissection of the descending aorta represent a formidable surgical challenge. Closed chest circulatory arrest in this setting carries a high risk of myocardial or brain damage. We propose a modification of the port-access technique that allows control and access of the pseudoaneurysm, avoiding the need for closed chest circulatory arrest. Our strategy is based on transaxillary endoclamping of the ascending aorta and combines the advantages of antegrade aortic flow with the possibility of stopping the heart and venting the left ventricle before sternotomy.

UI MeSH Term Description Entries
D003326 Coronary Circulation The circulation of blood through the CORONARY VESSELS of the HEART. Circulation, Coronary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000784 Aortic Dissection A tear in the inner layer of the AORTA leading to interstitial HEMORRHAGE, and splitting (dissecting) of the aortic TUNICA MEDIA layer. It typically begins with a tear in the TUNICA INTIMA layer. Aneurysm, Dissecting,Aortic Dissecting Aneurysm,Dissecting Aneurysm,Dissecting Aneurysm Aorta,Aneurysm Aorta, Dissecting,Aneurysm, Aortic Dissecting,Aorta, Dissecting Aneurysm,Aortic Dissecting Aneurysms,Aortic Dissections,Dissecting Aneurysm Aortas,Dissecting Aneurysm, Aortic,Dissecting Aneurysms,Dissection, Aortic
D001013 Aorta, Thoracic The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA. Aorta, Ascending,Aorta, Descending,Aortic Arch,Aortic Root,Arch of the Aorta,Descending Aorta,Sinotubular Junction,Ascending Aorta,Thoracic Aorta,Aortic Roots,Arch, Aortic,Ascending Aortas,Junction, Sinotubular,Root, Aortic,Sinotubular Junctions
D001018 Aortic Diseases Pathological processes involving any part of the AORTA. Aortic Disease,Disease, Aortic,Diseases, Aortic
D013525 Surgical Instruments Hand-held tools or implements used by health professionals for the performance of surgical tasks. Clamps, Surgical,Clips, Surgical,Clips, Tantalum,Forceps,Hooks, Surgical,Plugs, Surgical,Scissors, Surgical,Speculum,Surgical Clamps,Surgical Clips,Surgical Hooks,Surgical Plugs,Surgical Scissors,Surgical Valves,Trocar,Valves, Surgical,Clamp, Surgical,Clip, Surgical,Clips,Hook, Surgical,Instrument, Surgical,Plug, Surgical,Surgical Clamp,Surgical Clip,Surgical Hook,Surgical Plug,Surgical Valve,Valve, Surgical,Clip,Clip, Tantalum,Forcep,Instruments, Surgical,Speculums,Surgical Instrument,Tantalum Clip,Tantalum Clips,Trocars
D017541 Aneurysm, False Not an aneurysm but a well-defined collection of blood and CONNECTIVE TISSUE outside the wall of a blood vessel or the heart. It is the containment of a ruptured blood vessel or heart, such as sealing a rupture of the left ventricle. False aneurysm is formed by organized THROMBUS and HEMATOMA in surrounding tissue. Pseudoaneurysm,False Aneurysm,Aneurysms, False,False Aneurysms,Pseudoaneurysms

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