Moderate hypothermic circulatory arrest with antegrade cerebral perfusion for the open repair of juxtarenal abdominal aortic aneurysm repair with shaggy aorta

Yamini Vyas; Jane M Chung; Yakov L Elgudin; Jae S Cho

doi:10.1016/j.jvscit.2024.101643

Moderate hypothermic circulatory arrest with antegrade cerebral perfusion for the open repair of juxtarenal abdominal aortic aneurysm repair with shaggy aorta

J Vasc Surg Cases Innov Tech. 2024 Oct 17;11(1):101643. doi: 10.1016/j.jvscit.2024.101643. eCollection 2025 Feb.

Authors

Yamini Vyas¹, Jane M Chung¹, Yakov L Elgudin², Jae S Cho¹

Affiliations

¹ Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, University Hospitals, Harrington Heart and Vascular Institute, Cleveland, OH.
² Division of Cardiac Surgery, Department of Surgery, Case Western Reserve University School of Medicine, University Hospitals, Harrington Heart and Vascular Institute, Cleveland, OH.

Abstract

Shaggy aorta is severe luminal surface degeneration of the aorta leading to an increased risk of plaque destabilization and embolization to the peripheral or visceral vessel beds. It represents a challenging clinical entity for both endovascular and open repair owing to potential atheroembolization, increased early morbidity and mortality, and poor long-term survival. Patients may be denied repair owing to its high risks. Herein, we present a novel approach to open repair of a juxtarenal abdominal aortic aneurysm with shaggy aorta using moderate hypothermic circulatory arrest with antegrade cerebral perfusion and concurrent flow modification to mitigate the risk of atheroma embolism.