Reemplazo parcial o total del arco aórtico: Experiencia en 23 pacientes

Between 1988 and 2002, 23 patients wereoperated. Seventeen had aortic dissection (10 acute and 7 chronic), five had an atheroscleroticaneurysm and one had a traumatic lesion. Thirteen patients were subjected to a replacement of thearch plus ascending aorta, six to a replacement of the arch plus descending aorta and four to areplacement of the arch, ascending and descending aorta. Seven patients had previous operation ofthe thoracic aorta. Arterial perfusion was done via the femoral artery, axillary artery or a combinationof both. A hypothermic circulatory arrest was induced in 22; it was associated with cerebral retroperfusion alone in 8 patients, antegrade cerebral perfusion in 5; isolated or associated axillaryperfusion was used in five patients. In seven, procedures on the aortic or mitral valve, or coronaryartery operations were added. Operative mortality was 26%, 3 of the 8 patients operated as anemergency and 3 of 15 elective operations. There was no mortality among those without dissection andof 7 chronic dissections, one died. All patients were followed for an average of 45 months. Two patientsrequired reinterventions on the aorta and one for colon cancer. There was one late death of unknowncause. Postoperative complications were agitation, bleeding and temporary vocal cord dysfunction.