Key result
The transsternal transpericardial approach to the descending thoracic aorta via median sternotomy allowed for extensive single-stage aortic repair but resulted in a 30.8% incidence of spinal cord ischemia.
Why the study?
Conventional approaches for extensive aortic repair may be prohibited in certain patients, necessitating alternative surgical techniques.
Observational (n=15)
No
The transsternal and transpericardial approach via median sternotomy is a feasible option for extensive aortic repair in highly selected patients, though it carries a high risk of spinal cord ischemia.
High spinal cord ischemia risk warrants caution in extensive aortic repair; leaves open role for this approach in highly selected patients.
We describe a technique for approaching the distal descending thoracic aorta via median sternotomy and posterior pericardiotomy, which enabled us to perform the extensive aortic repair. While this approach shared the lesser invasiveness of the frozen elephant trunk procedure with less confinement by anatomic features, the advantage was counterbalanced by the high incidence of spinal cord ischemia. This approach can be an option in highly selected patients who require extensive aortic repair but have factors prohibiting other conventional approaches.
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Kay‐Hyun Park (2022) conducted an observational in Extensive thoracic aortic disease (aneurysm, chronic dissection) (n=15). Transsternal and transpericardial approach to descending thoracic aorta via median sternotomy was evaluated on Spinal cord ischemia (SCI) in extensive aortic replacement cases. The transsternal transpericardial approach to the descending thoracic aorta via median sternotomy allowed for extensive single-stage aortic repair but resulted in a 30.8% incidence of spinal cord ischemia.
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