Enrico Carone
University of Siena
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The Journal of Thoracic and Cardiovascular Surgery | 1999
Eugenio Neri; Massimo Massetti; Gianni Capannini; Enrico Carone; Enrico Tucci; Francesco Diciolla; Edvin Prifti; Carlo Sassi
BACKGROUND Femoral arteries are the preferred site of peripheral cannulation for arterial inflow in type A aortic dissection operations. The presence of aortoiliac aneurysms, severe peripheral occlusive disease, atherosclerosis of the femoral vessels, and distal extension of the aortic dissection may preclude their utilization. Axillary artery cannulation may represent a valid alternative in these circumstances. METHODS Between January 15, 1989, and August 20, 1998, in our institution, 22 of 152 operations (14.4%) for acute type A aortic dissection were performed with the use of the axillary artery for the arterial inflow. Axillary artery cannulation was undertaken in the presence of femoral arteries bilaterally compromised by dissection in 12 patients (54.5%), abdominal aorta and peripheral aneurysm in 5 patients (22.7%), severe atherosclerosis of both femoral arteries in 3 patients (13. 6%), and aortoiliac occlusive disease in 2 patients (9.1%). In all patients, distal anastomosis was performed with an open technique after deep hypothermic circulatory arrest. Retrograde cerebral perfusion was used in 9 patients (40.9%). RESULTS Axillary artery cannulation was successful in all patients. The left axillary artery was cannulated in 20 patients (90.9%), and the right axillary artery was cannulated in 2 patients (9.1%). Axillary artery cannulation followed an attempt of femoral artery cannulation in 15 patients (68. 2%). All patients survived the operation, and no patient had a cerebrovascular accident. No axillary artery thrombosis, no brachial plexus injury, and no intraoperative malperfusion were recorded in this series. Two patients (9.1%) died in the hospital of complications not related to axillary artery cannulation. CONCLUSIONS In patients with type A aortic dissection in whom femoral arteries are acutely or chronically diseased, axillary artery cannulation represents a safe and effective means of providing arterial inflow during cardiopulmonary bypass.
The Annals of Thoracic Surgery | 1999
Eugenio Neri; Gianni Capannini; Enrico Carone; Francesco Diciolla; Carlo Sassi
Intramural hematoma of the aorta is a condition increasingly observed in clinical practice. Uncertainty exists whether such lesions represent a different pathology or simply the precursors of classic dissecting aneurysm. The patient was a 76-year-old woman with intramural hematoma of the ascending aorta. Clinical course, progression of the lesion to type A aortic dissection, and surgical treatment are described. Although natural history of intramural hematoma of the ascending aorta is not clearly elucidated, the case presented confirms that the evolution toward intimal flap formation is possible and that we cannot foresee the stabilization of these lesions. We stress that intramural hematoma of the ascending aorta has to be managed as an aortic type A dissection and that aggressive treatment is advisable.
The Annals of Thoracic Surgery | 1999
Eugenio Neri; Massimo Massetti; Gianni Capannini; Enrico Carone; Carlo Sassi
In operations for aortic dissection anastomotic bleeding or secondary anastomosis dehiscence are common problems. The advent of Gelatin-resorcin-formaldehyde-glutaraldehyde (GRF) biologic glue has ameliorated type A dissection operative management. Glue containment is mandatory since detrimental effects of glue migration are described. We herein present a simple technique of anastomosis reinforcement and glue containment that helps in overcoming these complications.
The Annals of Thoracic Surgery | 1999
Eugenio Neri; Gianni Capannini; Enrico Carone; Enrico Tucci; Carlo Sassi
Acute cardiac failure during descending thoracic aorta operations, although rare, may have catastrophic consequences. Under these circumstances, the use of partial veno arterial bypass is advantageous, allowing an assisted perfusion of both proximal and distal circulation districts. Traditionally, the ascending aorta or the aortic arch are the preferred sites of cannulation for proximal arterial reinfusion, but some limitations, such as extensive calcifications or extreme fragility of these segments, may hamper or at least delay this action. Herein, we describe a simple technique for rapid cannulation of proximal aorta in emergency circumstances.
Journal of Vascular Surgery | 2000
Eugenio Neri; Gianni Capannini; Francesco Diciolla; Enrico Carone; Alberto Tripodi; Enrico Tucci; Carlo Sassi
The Journal of Thoracic and Cardiovascular Surgery | 1999
Eugenio Neri; Massimo Massetti; Piero Tanganelli; Gianni Capannini; Enrico Carone; Alberto Tripodi; Enrico Tucci; Carlo Sassi
Texas Heart Institute Journal | 2004
Giuseppe Davoli; Federico Bizzarri; Enrico Tucci; Enrico Carone; Luigi Muzzi; Giacomo Frati; Mario Chiavarelli
The Journal of Thoracic and Cardiovascular Surgery | 1999
Eugenio Neri; Clelia Miracco; Pietro Luzi; Enrico Carone; Alberto Tripodi; Carlo Sassi
The Journal of Thoracic and Cardiovascular Surgery | 1999
Eugenio Neri; Gianni Capannini; Enrico Carone; Enrico Tucci; Francesco Diciolla; Carlo Sassi
The Journal of Thoracic and Cardiovascular Surgery | 1999
Eugenio Neri; Enrico Carone; Gianni Capannini; Enrico Tucci; Francesco Diciolla; Carlo Sassi