Key result
Beating-heart total arch replacement succeeds in an 84-year-old with severe HF by minimizing arrest times.
Why the study?
Patients of advanced age with severely reduced cardiac function may not be candidates for conventional TAR, and reducing operative, cardiac arrest, and circulatory arrest times is needed.
Case Report (n=1)
Beating-heart total arch replacement may be a feasible surgical option for elderly patients with severe heart failure and extended aortic arch aneurysms.
Answers are grounded in this paper and cite their sources.
May enable TAR in select frail octogenarians with poor function; single-case report leaves open need for prospective validation.
Surgical outcomes of total arch replacement (TAR) have improved dramatically over the last decades. However, patients of advanced age and with a severely reduced cardiac function and an extended aortic arch aneurysm may not be candidates for conventional TAR. Endovascular and hybrid treatment for extended aortic aneurysm have demonstrated lower mortality and morbidity, and considered for the advanced age and high-risk patients. But endovascular with total de-branching technique remains challenging with the slightly dilated ascending aorta. Reducing the operation time, cardiac arrest time, and circulatory arrest time should be needed to resolve the problem for the conventional TAR with an advanced age and a severely reduced cardiac function. We herein introduce our surgical technique for the case of an 84-year-old man with a severely reduced cardiac function, who was successfully treated with beating heart TAR with minimization of the operation time, cardiac arrest time, and circulatory arrest time.
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Mutsuga et al. (2021) conducted a case report in Extended aortic arch aneurysm and severe heart failure (n=1). Beating-heart total arch replacement was evaluated on Successful treatment with minimization of operation time, cardiac arrest time, and circulatory arrest time. Beating-heart total arch replacement was successfully performed in an 84-year-old man with severe heart failure, minimizing operation, cardiac arrest, and circulatory arrest times.
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