Peripheral cannulation and endoaortic balloon occlusion for management of porcelain aorta during cardiac surgery.
Kevin Edward HodgesRaphaelle A ChemtobAnand R MehtaGosta B PetterssonPublished in: Journal of cardiac surgery (2022)
Porcelain aorta with extensive calcification of the ascending aorta complicates cardiac surgery and increases perioperative risk. Aortic cannulation and cross-clamping in these patients increase the risk of serious complications including perioperative embolic stroke. Although different techniques have been proposed, surgery in these patients remains a challenge. We present the clinical implications of the porcelain aorta and surgical strategies involving axillary arterial cannulation and endoaortic balloon to allow for the institution of cardiopulmonary bypass and cardioplegic arrest during surgery. The surgery included a redo sternotomy with bioprosthetic mitral valve replacement, tricuspid valve repair with an annuloplasty, and closure of the left atrial appendage. In appropriately selected patients, endoaortic balloon occlusion was a valuable tool to facilitate the safe conduct of an operation. Careful preoperative evaluation and planning by a multidisciplinary team are essential in these cases.
Keyphrases
- mitral valve
- aortic valve
- cardiac surgery
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- ejection fraction
- pulmonary artery
- patients undergoing
- atrial fibrillation
- coronary artery bypass
- acute kidney injury
- heart failure
- peritoneal dialysis
- aortic valve replacement
- transcatheter aortic valve replacement
- coronary artery
- radiation therapy
- pulmonary hypertension
- left ventricular
- palliative care
- left atrial
- aortic dissection
- acute coronary syndrome
- risk factors