Technique

Combined Hypothermic Circulatory Arrest and Warm Blood Cardioplegia for Aortic Surgery

Victor Valley Heart and Vascular Institute, Victorville, California

^* Address correspondence to: David B. DiMarco, MD, 4221 Penn Avenue- Suite G-103, Pittsburgh, PA 15224

Abstract

This is a case of an 87-year-old male who underwent successful repair of an acute ascending aortic dissection (Stanford Type A). Hypothermic circulatory arrest was used to provide cerebral protection during the performance of the "open" distal anastomosis. Continuous normothermic retrograde blood cardioplegia was used as a means for myocardial protection. To our knowledge, this is the first report of combining warm (aerobic) cardiac preservation with hypothermic circulatory arrest. We describe the perfusion management and discuss the rationale for the use of normothermic blood cardioplegia. We advocate the use of warm aerobic myocardial arrest for all procedures requiring myocardial protection regardless of systemic temperature.