{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T04:58:08Z","timestamp":1667451488652},"reference-count":0,"publisher":"European Association of Cardiothoracic Surgery (EACTS Publishing Ltd)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MMCTS"],"abstract":"<jats:p>We propose a technique to minimize the neurological and systemic risks involved in rerouting the blood flow toward the brain in a \u201csingle remaining vessel\u201d configuration with a 90% stenosis by means of complete hypothermic cerebral protection associated with normothermic systemic blood flow with a \u201crestitutio ad integrum\u201d of the supra-aortic trunks flow. The perfusion of the brain and the arms was almost completely separated from the systemic perfusion by the deployment 1 year before of a thoracic endoprosthesis in association with complete chronic occlusion of the brachiocephalic trunk and a functioning carotid-subclavian bypass. The Free Flow of the prosthesis, which acted as a hook, moved the calcium toward the left carotid ostium, creating a 90% stenosis with intermittent acute cerebral hypoperfusion and amaurosis. We achieved an optimal result: The patient was discharged on postoperative day 7 with no neurological problems and with patency and direct blood flow in all the supra-aortic trunks.<\/jats:p>","DOI":"10.1510\/mmcts.2021.034","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T15:57:12Z","timestamp":1637164632000},"source":"Crossref","is-referenced-by-count":0,"title":["Open supra-aortic revascularization and arch reconstruction after previous TEVAR in a complex arch anatomy"],"prefix":"10.1510","member":"10966","published-online":{"date-parts":[[2021,11,17]]},"container-title":["The Multimedia Manual of Cardio-Thoracic Surgery"],"original-title":[],"deposited":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T16:03:50Z","timestamp":1667405030000},"score":1,"resource":{"primary":{"URL":"https:\/\/mmcts.org\/tutorial\/1656"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,17]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1510\/mmcts.2021.034","relation":{},"subject":[],"published":{"date-parts":[[2021,11,17]]}}}