Surgical results for thoraco-abdominal XXXX by modified DeBakey method using centrifugal biopump and renal cryopreservation.

@entity1 @entity8 @entity451 @entity583 @entity3665 @entity39 @entity254 @entity260 @entity177 @entity439 @entity2224 @entity731
BACKGROUND: In this paper, we report the surgical results of our DeBakey and Crawford combined method. METHODS: From 1985 to 1995, 22 consecutive @entity1 with thoraco-abdominal aneurysms underwent a modified DeBakey and Crawford combined procedure to minimize the ischemic time for the spinal cord and visceral organs. The extent of @entity439 as classified by Crawford was as follows: Group I, 12; Group II, 4, Group III, 3; Group IV, 3. The etiology of the @entity439 was @entity731 in 19, @entity39 in 2, and @entity3665 in 1. The @entity439 was approached through the spiral opening method. First, end-to-side distal @entity254 was performed above the bifurcation under partial aortic clamping, and this was followed by proximal @entity254 . During the end-to-end proximal @entity254 , a Gott shunt tube or heparinless left heart bypass was used. In two @entity1 , @entity8 had been previously reconstructed by a saphenous vein graft extending from the left common iliac artery. Then @entity439 was opened, and the right renal artery and superiors mesenteric artery were perfused with cold blood. In two @entity1 , partial cardiopulmonary bypass and selective perfusion were performed. In eight @entity1 , renal artery, celiac artery, superior mesenteric artery, and intercostal artery were reconstructed with a branch graft. RESULTS: No @entity1 died within 30 days of surgery, however, one @entity1 died of @entity583 (POD 54) and another of @entity2224 during hemodialysis (POD 60). @entity260 included @entity451 , and @entity177 requiring dialysis each in two @entity1 . Postoperative angiography revealed 18/19 (94.7%) of grafts were patent. CONCLUSIONS: In conclusion, by using different techniques for spinal cord and visceral protection, including the Gott shunt, Biomedicus pump, renal cryopreservation, and separate revascularization of viscera and intercostal arteries, good results could be obtained.
