Espinoza-Hernández JD, Venegas-González U, Carrillo-Zamarripa G, Marroquín-Romero R, Villarreal-Rubio CB, Corral-Palacios R

Language: English
References: 10
Page: 18-21
PDF size: 261.34 Kb.

ABSTRACT

Introduction. Left heart bypass (LHB) was first described in 1957. Disruption of blood flow to the spinal cord and abdominal viscera contributes to the development of ischemic complications. The aim of this technique is to ensure distal organ perfusion to avoid ischemic complications during descending aortic surgery. Objective. We sought to demonstrate the efficacy and safety of the left bypass as circulatory assistance in descending aortic surgery by presenting our initial experience. Material. Fifteen patients with descending aortic pathology and undergoing surgery, were studied from April 2011 to December 2019. The age range was 13 to 74 years. The most common etiology was aortic coarctation. The serum lactate, serum creatinine and liver enzyme values were revised in preoperative, immediate postoperative and hospital discharge. Results. In all of cases the left heart drained was through left atrium an inflow cannula in the femoral artery (3 cases 20%) or distal aorta (12 cases 80%); the size of the graft ranged from 14 to 24 mm. The mean cross-clamp time was 48.1 minutes (range 38.5 to 88.1 minutes). There were no severe alterations in biochemical parameters after bypass and muscle strength was not affected in any of the patients. We did not have any complications. In follow-up to 6 months the patients are developing a normal life. Conclusions. LHB for repair of the descending aortic pathology allowing an accurate surgery without time pressure. We would recommend its use to increase the safety margin in the high-risk population especially in hospitals where we do not routinely have this type of surgery.

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