Thoracic aortic operations: management of maldistribution of arterial flow during cardiopulmonary bypass

On three occasions during operations for aortic aneurysm involving the ascending aorta it was noted that upon the release of the aortic clamp the grafted segment remained collapsed, indicating very little or no flow reaching the lumen of the reconstructed aorta. This was promptly and successfully remedied in 2 patients by perfusing the graft directly with a pediatric arterial catheter attached to a pump head while the femoral arterial line maintained systemic arterial inflow. This simple, safe, and highly effective technique adds to the surgeonʹs repertoire to manage yet another intriguing intraoperative development during thoracic aortic operations.