Transapical aortic perfusion using a deep hypothermic procedure to prevent dissecting lung injury during re-do thoracoabdominal aortic aneurysm surgery

Yuya Kise, Yukio Kuniyoshi, Mizuki Ando, Hitoshi Inafuku, Takaaki Nagano, Satoshi Yamashiro

Avoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery. A 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis. The deep hypothermia was induced with bilateral infusion of cardiopulmonary bypass by femoral artery cannulation for the lower body and by transapical cannulation for the upper body because of easy access. There was no hemorrhagic tendency after deep hypothermic bypass. The patient was discharged uneventfully. For upper body perfusion, transapical aortic cannulation was a simple and effective procedure during left thoracotomy.