Aortic Arch Replacement for Arch Aneurysm with a Porcelain Aorta Using Transapical Aortic Cannulation

iDepartment of Cardiovascular Surgery, Kawasaki Saiwai Hospital, Kawasaki, Japanj

Yoshiyuki Nishimura Shin Yamamoto Hideichi Wada
Hiromine Fujita Yasuyuki Hosoda
Porcelain aorta entails a high risk of cerebral as well as systemic embolism. We describe a case of aortic arch aneurysm with a circumferentially calcified aorta. The patient was a 61-year-old man on chronic hemodialysis who received aortic arch replacement. However, since chest CT scan revealed a totally calcified porcelain aorta and heavily calcified axillary artery, axillary artery cannulation was deemed to be contraindicated. On the other hand, possible complications caused by femoral artery cannulation are also well known, such as cerebral embolization. Therefore, transapical aortic cannula was used and aortic arch replacement was performed under deep hypothermic circulatory arrest. The patient was weaned from cardiopulmonary bypass without difficulty and had an uneventful recovery without any neurologic complications.
  Jpn. J. Cardiovasc. Surg. 38:223-225i2009j