Surgical and Subsequent Endovascular Treatment of a False Aneurysm of the Aortic Arch
| Autor: | H. Rousseau, D. Roux, B. Leobon, A. Mugniot, Y. Glock, G. Fournial |
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| Rok vydání: | 2004 |
| Předmět: |
Aortic arch
medicine.medical_specialty Aorta Aortic Arch business.industry Covered stent graft Bentall procedure Surgical bypass Dissection (medical) Anastomosis medicine.disease Surgery Aneurysm Aortic valve replacement False aneurysm medicine.artery cardiovascular system medicine Radiology Common carotid artery business Cardiology and Cardiovascular Medicine |
| Zdroj: | EJVES Extra. 7(1):15-17 |
| ISSN: | 1533-3167 |
| DOI: | 10.1016/s1533-3167(03)00112-2 |
| Popis: | IntroductionRedo surgery of the aortic arch in elderly patients inpoor health is associated with a high mortality. Thisregion of the aorta cannot always be treated usingendovascular stents. We report our experience with asurgical case of a false anastomotic aneurysm of theaortic arch, treated by open surgery and subsequentendovascular surgery.Case ReportA 74-year-old patient with a persistent hiccoughunderwent a routine medical examination. He hadundergone an aortic valve replacement in 1982followed by a Bentall procedure and an aortic archreplacement in 1986 due to a dissection. Radiographyand the thoracic computerized tomography revealed afalse aneurysm of the distal anastomosis of the aorticarch, fed by a localized leak at the origin of thebrachiocephalic trunk (Fig. 1). The neck between theleak and the brachiocephalic trunk was 0.7 cm. Anendovascular procedure as the first option wasconsidered because of the patient’s medical historyand his precarious coronary condition.First, via a cervical approach, the left subclavianartery was reimplanted into the left common carotidartery, a carotid–carotid bypass graft and exclusion ofthe left common carotid artery were achieved. Apostoperative surgical haemostasis and a bloodtransfusion were both required. Postoperative com-plications included a left recurrent laryngeal nerveparalysis,pneumonia,and theonsetof atrialfibrillation.Because of these complications we waited 6 monthsbefore carrying out the endovascular procedure.At the second procedure an occlusion balloon wasfirst placed in the left subclavian artery to preventretrograde perfusion from the collaterals from feeding |
| Databáze: | OpenAIRE |
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