Improved derivation for uncontrolled bleeding in aortic root and arch surgery

Department of Cardiac Surgery, Na Homolce Hospital, Prague, Czech Republic *Corresponding author. Department of Heart Surgery, Na Homolce Hospital, Roentgenova 2, 150 30 Prague 5, Czech Republic. Tel.: +49 201 723 85578; fax: +49 201 723 5451. E-mail address : jaroslav.benedik{at}homolka.cz (J. Benedik). Uncontrolled bleeding post root, ascending aorta and aortic arch operations can occur. Various techniques for getting bleeding under control have already been published in the literature. This life-threatening complication happens especially during acute aortic dissection and acute endocarditis operations, the former sometimes requiring complex mobilization of the aortic arch and the use of branched prosthetic grafts. In this report we describe the simple innovation of the technique which creates a relatively small space surrounding the aortic graft by its wrapping with use of the pericardium. Decompression of this space is maintained to a low-pressure system. Key Words: Aortic arch; Aortic root; Aortic dissection; Pericardium; Surgery complications