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Short and mid-term results of the “double aorta” technique: A new surgical method without use of an extracorporeal circulation

      The use of extracorporal circulation (ECC) for the open surgery of thoracoabdominal aneurysms (TAA) remains a technique of reference. The prolonged use of ECC for very extensive TAA can involve complications specific to this method: important blood losses, hemolysis with its effects on the renal, hepatic and pulmonary functions. To palliate these complications and to avoid the use of ECC, we propose a technique of “double aorta”. The creation of a double parallel circulation was developed by our team in order to ensure an adapted blood flow to the internal organs and the lower extremities without needing an ECC. The double aorta model is created “to measure” during the operation. We first create a “mobile” aorta which allows the revascularization of the digestive arteries and the left renal artery from the left iliac axis then we replace the pathological aorta, called “fixed” aorta with a reimplantation of the intercostal arteries, the right renal artery, and the right iliac artery. The objective of this work was to evaluate the results of the technique at D30, one and two years in terms of mortality, neurological, renal, and digestive complications, and to evaluate the patency of the vessels.
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