Korean J Thorac Cardiovasc Surg.
2010 Dec;43(6):769-773.
The Use of Rapid Ventricular Pacing to Facilitate Stent Graft Deployment in the Distal Aortic Arch
- Affiliations
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- 1Department of Thoracic and Cardiovascular Surgery, Kangpuk Samsung Hospital, Sungkyunkwan University College of Medicine, Korea. joonhyukkong@empas.com
- 2Department of Anesthesiology and Pain Medicine, Daegu Veterans Hospital, Korea.
- 3Department of Thoracic and Cardiovascular Surgery, Andong General Hospital, Korea.
- 4Department of Thoracic and Cardiovascular Surgery, CHA Gumi Medical Center, CHA University, Korea.
Abstract
- Systemic hypotension has been traditionally used to facilitate deployment of thoracic stent grafts. Decreasing blood pressure with vasodilating agents further increases cardiac output and, consequently, the cardiac output-mediated windsock effect during deployment. Use of rapid ventricular pacing reduces the windsock effect during stent graft deployment and allows the graft to appose to the aortic wall under zero cardiac output, thus minimizing aortic wall shear stress. In this case we report the use of transvenous rapid ventricular pacing, a safe and reproducible technique to allow precise deployment of a Valiant Captivia stent graft in the distal thoracic arch for a saccular thoracic aneurysm.