Victoria-Medina Wilfredo Luna, Quispe-Vizcarra Carlos, Rojas-Huillca Miguel, Moreno-Loaiza Milagros, Cubas W Samir
Service of Heart Surgery, Department of Thoracic and Cardiovascular Surgery, Edgardo Rebagliati Martins National Hospital, Avenue Rebagliati 490, Jesus Maria, Lima, Peru.
Egypt Heart J. 2022 Feb 21;74(1):12. doi: 10.1186/s43044-022-00248-y.
The surgical approach to pathologies of the Ascending Thoracic Aorta (ATA) that compromise aortic root and the aortic arch is currently one of the most complex interventions in the spectrum of cardiac surgery, where circulatory arrest with cerebral perfusion plays an important role for Success postoperative and patient survival.
We present the case of a 57-year-old patient with the only history of arterial hypertension and an ATA Aneurysm that compromised segment of the aortic root up to segment 2 of the aortic arch. A successful Bentall surgery was performed, debranching supra-aortic vessels with Total Circulatory Arrest with Deep Hypothermic Cerebral Perfusion-Antegrade Bilateral.
With the advent of new anesthetic and neuroprotection techniques, perioperative imaging protocols, advanced hemodynamic monitoring, and invaluable advances in perfusion and Extracorporeal Circulation with circulatory arrest, they have made this surgical challenge a valuable tool for today's cardiovascular surgeon.
对于累及主动脉根部和主动脉弓的升胸主动脉（ATA）病变，手术方法目前是心脏手术领域中最复杂的干预措施之一，在此类手术中，采用脑灌注的循环停止对术后成功及患者存活起着重要作用。
我们呈现了一名57岁患者的病例，该患者仅有动脉高血压病史，患有ATA动脉瘤，累及主动脉根部直至主动脉弓第2段。成功实施了Bentall手术，在全循环停止及深低温脑灌注 - 顺行双侧脑灌注的情况下对主动脉弓上血管进行去分支。
随着新的麻醉和神经保护技术、围手术期成像方案、先进的血流动力学监测以及循环停止时灌注和体外循环方面的宝贵进展的出现，它们使这一手术挑战成为当今心血管外科医生的一项重要工具。
