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Impact of hybrid thoracoabdominal aortic repair on visceral and spinal cord perfusion

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Impact of hybrid thoracoabdominal aortic repair on visceral and spinal cord perfusion : The new and improved SPIDER-graft. / Wipper, Sabine; Kölbel, Tilo; Sandhu, Harleen K; Manzoni, Daniel; Duprée, Anna; Estrera, Anthony L; Safi, Hazim; Miller, Charles C; Tsilimparis, Nikolaos; Debus, E Sebastian.

In: J THORAC CARDIOV SUR, Vol. 158, No. 3, 09.2019, p. 692-701.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Wipper, S, Kölbel, T, Sandhu, HK, Manzoni, D, Duprée, A, Estrera, AL, Safi, H, Miller, CC, Tsilimparis, N & Debus, ES 2019, 'Impact of hybrid thoracoabdominal aortic repair on visceral and spinal cord perfusion: The new and improved SPIDER-graft', J THORAC CARDIOV SUR, vol. 158, no. 3, pp. 692-701. https://doi.org/10.1016/j.jtcvs.2018.11.133

APA

Wipper, S., Kölbel, T., Sandhu, H. K., Manzoni, D., Duprée, A., Estrera, A. L., Safi, H., Miller, C. C., Tsilimparis, N., & Debus, E. S. (2019). Impact of hybrid thoracoabdominal aortic repair on visceral and spinal cord perfusion: The new and improved SPIDER-graft. J THORAC CARDIOV SUR, 158(3), 692-701. https://doi.org/10.1016/j.jtcvs.2018.11.133

Vancouver

Wipper S, Kölbel T, Sandhu HK, Manzoni D, Duprée A, Estrera AL et al. Impact of hybrid thoracoabdominal aortic repair on visceral and spinal cord perfusion: The new and improved SPIDER-graft. J THORAC CARDIOV SUR. 2019 Sep;158(3):692-701. https://doi.org/10.1016/j.jtcvs.2018.11.133

Bibtex

@article{d95e52656783472cb6ebb53fe3e54b5b,
title = "Impact of hybrid thoracoabdominal aortic repair on visceral and spinal cord perfusion: The new and improved SPIDER-graft",
abstract = "OBJECTIVES: SPIDER-graft for thoracoabdominal aortic aneurysm repair avoiding thoracotomy and extracorporeal circulation was modified, enabling reimplantation of lumbar arteries to prevent spinal cord ischemia and compared with open aortic repair (control) in a pig model.METHODS: Graft implantation was performed in 7 pigs per group (75-85 kg). For SPIDER-graft (groups I and II), the infra-diaphragmatic aorta was exposed through retroperitoneal access. The right iliac branch was first temporarily anastomosed end-to-side to the distal aorta maintaining periprocedural retrograde visceral perfusion. SPIDER-graft was deployed in the descending thoracic aorta via the celiac artery ostium. The celiac, superior mesenteric, and renal arteries were successively connected to the corresponding side branches of the graft. In group II, the lumbar arteries were reimplanted into the former access branch. For control, complete thoracoabdominal exposure of the aorta was required. After crossclamping, proximal anastomosis was performed, and the celiac artery, superior mesenteric artery, renal arteries, and iliac arteries were reattached. Technical feasibility, ischemic times, blood flow, and visceral and spinal cord perfusion in the related organs were evaluated before implantation and 3 and 6 hours after implantation using transit-time flow measurement and fluorescent microspheres.RESULTS: Technical success was achieved in all animals in all groups. Total aortic clamping time and selective ischemic times of related organs were significantly longer during open aortic repair compared with groups I and II (P < .0001). Fluorescent microspheres confirmed best spinal cord perfusion in group II.CONCLUSIONS: SPIDER-graft reduced ischemic time, avoided extracorporeal circulation and thoracotomy, and improved spinal cord perfusion during thoracoabdominal aortic aneurysm repair in a pig model.",
author = "Sabine Wipper and Tilo K{\"o}lbel and Sandhu, {Harleen K} and Daniel Manzoni and Anna Dupr{\'e}e and Estrera, {Anthony L} and Hazim Safi and Miller, {Charles C} and Nikolaos Tsilimparis and Debus, {E Sebastian}",
note = "Copyright {\textcopyright} 2018 The American Association for Thoracic Surgery. All rights reserved.",
year = "2019",
month = sep,
doi = "10.1016/j.jtcvs.2018.11.133",
language = "English",
volume = "158",
pages = "692--701",
journal = "J THORAC CARDIOV SUR",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "3",

}

RIS

TY - JOUR

T1 - Impact of hybrid thoracoabdominal aortic repair on visceral and spinal cord perfusion

T2 - The new and improved SPIDER-graft

AU - Wipper, Sabine

AU - Kölbel, Tilo

AU - Sandhu, Harleen K

AU - Manzoni, Daniel

AU - Duprée, Anna

AU - Estrera, Anthony L

AU - Safi, Hazim

AU - Miller, Charles C

AU - Tsilimparis, Nikolaos

AU - Debus, E Sebastian

N1 - Copyright © 2018 The American Association for Thoracic Surgery. All rights reserved.

PY - 2019/9

Y1 - 2019/9

N2 - OBJECTIVES: SPIDER-graft for thoracoabdominal aortic aneurysm repair avoiding thoracotomy and extracorporeal circulation was modified, enabling reimplantation of lumbar arteries to prevent spinal cord ischemia and compared with open aortic repair (control) in a pig model.METHODS: Graft implantation was performed in 7 pigs per group (75-85 kg). For SPIDER-graft (groups I and II), the infra-diaphragmatic aorta was exposed through retroperitoneal access. The right iliac branch was first temporarily anastomosed end-to-side to the distal aorta maintaining periprocedural retrograde visceral perfusion. SPIDER-graft was deployed in the descending thoracic aorta via the celiac artery ostium. The celiac, superior mesenteric, and renal arteries were successively connected to the corresponding side branches of the graft. In group II, the lumbar arteries were reimplanted into the former access branch. For control, complete thoracoabdominal exposure of the aorta was required. After crossclamping, proximal anastomosis was performed, and the celiac artery, superior mesenteric artery, renal arteries, and iliac arteries were reattached. Technical feasibility, ischemic times, blood flow, and visceral and spinal cord perfusion in the related organs were evaluated before implantation and 3 and 6 hours after implantation using transit-time flow measurement and fluorescent microspheres.RESULTS: Technical success was achieved in all animals in all groups. Total aortic clamping time and selective ischemic times of related organs were significantly longer during open aortic repair compared with groups I and II (P < .0001). Fluorescent microspheres confirmed best spinal cord perfusion in group II.CONCLUSIONS: SPIDER-graft reduced ischemic time, avoided extracorporeal circulation and thoracotomy, and improved spinal cord perfusion during thoracoabdominal aortic aneurysm repair in a pig model.

AB - OBJECTIVES: SPIDER-graft for thoracoabdominal aortic aneurysm repair avoiding thoracotomy and extracorporeal circulation was modified, enabling reimplantation of lumbar arteries to prevent spinal cord ischemia and compared with open aortic repair (control) in a pig model.METHODS: Graft implantation was performed in 7 pigs per group (75-85 kg). For SPIDER-graft (groups I and II), the infra-diaphragmatic aorta was exposed through retroperitoneal access. The right iliac branch was first temporarily anastomosed end-to-side to the distal aorta maintaining periprocedural retrograde visceral perfusion. SPIDER-graft was deployed in the descending thoracic aorta via the celiac artery ostium. The celiac, superior mesenteric, and renal arteries were successively connected to the corresponding side branches of the graft. In group II, the lumbar arteries were reimplanted into the former access branch. For control, complete thoracoabdominal exposure of the aorta was required. After crossclamping, proximal anastomosis was performed, and the celiac artery, superior mesenteric artery, renal arteries, and iliac arteries were reattached. Technical feasibility, ischemic times, blood flow, and visceral and spinal cord perfusion in the related organs were evaluated before implantation and 3 and 6 hours after implantation using transit-time flow measurement and fluorescent microspheres.RESULTS: Technical success was achieved in all animals in all groups. Total aortic clamping time and selective ischemic times of related organs were significantly longer during open aortic repair compared with groups I and II (P < .0001). Fluorescent microspheres confirmed best spinal cord perfusion in group II.CONCLUSIONS: SPIDER-graft reduced ischemic time, avoided extracorporeal circulation and thoracotomy, and improved spinal cord perfusion during thoracoabdominal aortic aneurysm repair in a pig model.

U2 - 10.1016/j.jtcvs.2018.11.133

DO - 10.1016/j.jtcvs.2018.11.133

M3 - SCORING: Journal article

C2 - 30745044

VL - 158

SP - 692

EP - 701

JO - J THORAC CARDIOV SUR

JF - J THORAC CARDIOV SUR

SN - 0022-5223

IS - 3

ER -