0
Cardiothoracic Surgery |

Modification of Cabrol Shunt in Redo-Aortic Root Surgery FREE TO VIEW

Chan-Young Na, PhD
Author and Funding Information

Keimyung University, School of Medicine, Daegu, Republic of Korea


Chest. 2014;146(4_MeetingAbstracts):91A. doi:10.1378/chest.1962941
Text Size: A A A
Published online

Abstract

SESSION TITLE: Cardiothoracic Surgery Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Bleeding after redo-aortic root replacement may be impossible to control in a certain situation.

METHODS: 45 years old male patient with Behcet disease had history of aortic valve replacment with mechanical valve and transvenous permanent pacemaker implantation at 8 years ago and then he had replacced aortic root with aortic homograft due to severe aortic regurgitation and aortic prosthetic valve annular dehiscence at 7 years ago. He presented severe aortic regurgitation and severe homograft calcification due to aortic homograft failure(Fig 1). Patient was replaced with aortic root using button Bentall technique with St. Jude composite graft(St. Jude Medical, St. Paul, MN, USA). On-going bleeding from many operative sites occurred, including bleeding from aortic annular and both coronary button anastomosis sites due to aortic homograft calcificaiton. Bleeding continued despite of conventional maneuvers, including application of sutures, topical hemostatic agents, and recombinant factor VII. .As a result, a bovine pericardial patch( approximately 8 x 10cm) was tailored to isolate the area of bleeding from aortic root . Suturing the patch proceeded from the superior vena cava laterally on the patient’s right side along the right atrium inferiorly, and the border of the heart and pulmonary artery on the patient’s left side. After aortic root exclusion with bovine pericardial aptch, bovine patch was bulging due to bleeding and hypotension were noticed, so we decided to connect the cavity covered by bovine pericaridial patch to superior vena caval cannualtions sites using Goretex tube graft 6mm(Fig. 2).

RESULTS: Bleeding was controlled, as blood from aortic root suture line and adjacent tissue was redirected to superior vena cava creating autotransfusion of shed bloods as described originally by Cabrol and coleagues.

CONCLUSIONS: Modified Cabrol shunt allows an option for dealing with severe bleeding in redo complex aortic root surgery.

CLINICAL IMPLICATIONS: This technique can reduce postopertive bleeding in complex redo-aortic root surgery.

DISCLOSURE: The following authors have nothing to disclose: Chan-Young Na

No Product/Research Disclosure Information


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543