A study on an auxiliary technique for arch replacement under normothermic conditions without cardiac arrest

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Aortic arch replacement requires deep hypothermic circulatory arrest(DI-ICA)and is associated with many postoperative complications.Improved surgical outcome would be anticipated if extracorporeal circulation could be achieved under normothermic conditions without cardiac arrest.The objective of the present study was to clarify the optimal conditions for such replacement surgery.[Methods]Electrocardiography(EGG), left atrial pressure(LAP), ascending aortic root pressure(Ao root Pre)and feinoral artery pressure(FAP)were monitored in beagle dogs.After initiation of F-F bypass, the ascending aorta(Asc Ao)was clamped.Monitoring was coniinued ntil animals were weaned from extracorporeal circulation(EGG).Animals were divided into two groups: those with coronary perfusion via the aortic root(2ml/mm/kg), and those without coronary perfusion.[Results]1)In all subjects in both groups, cardiac activity was maintained throughout 120 minutes of aortic clamping. 1-lemodynamics remained stable even after the clamp was released, and weaning from extracorporeal circulation was straightforward.2)in the group without coronary perfusion, left atrial pressure started to increase stalling 80 minutes after clamping, reaching a peak of 15 mmHg at 90 minutes after clainping.[Conclusions]As an auxiliary technique during arch replacement,. clamping of the ascending aorta is possible under normothermic conditions without cardiac an-est, and concurrent coronary perfusion is important for maintaining heinodynamic stability.