The New Delivery Method for Cardioplegic Solution in Type A Aortic Dissection.

Adequate myocardial protection is crucial for a successful cardiac surgery. In type A aortic dissection, standard methods of delivery of cardioplegic solution may not be adequately effective. Ineffectiveness may happen due to both features of the anatomy of the dissection and to peculiarities of the delivery method itself.

Penza's Surgical Maneuver: A Key to Tackle Complex Proximal Descending Thoracic Aortic Infectious or Malignant Issues.

We performed off-pump ascending-to-descending aortic grafting with the debranching of left carotid and subclavian arteries and total aortic arch transection in three patients. We have called this technique "Penza's Surgical Maneuver" and propose it for a safe surgery in cases where the aortic arch, the aortic isthmus, the beginning segment of the descending aorta, the esophagus, and a lung are diseased.

One more method for arterial cannulation in aortic arch surgery ("Penza cannulation").

Here we propose a new method of aortic cannulation in type A aortic dissection and aortic arch aneurysms. Aortic cannulation is performed through any of the ostia of brachiocephalic arteries and has been successfully used in 77 patients. This procedure is simple, safe, effective, and might be used as one of the alternatives to the classic methods of arterial cannulation.