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Total aortic arch aneurysm repair using a stent graft without cardiac or cerebral ischemia

  • Junichi Naganuma
  • Mikio Ninomiya
  • Takeshi Miyairi
  • Yutaka Kotsuka
  • Shinichi Takamoto
Article

Abstract

A 74-year-old man with an aortic arch aneurysm and a chronic type IIIb aortic dissection underwent total aortic arch repair without cerebral or cardiac ischemia. After confirming no atheromatous change in the ascending aortic wall, a custom-designed 4-limbed graft, prepared for both arterial return of cardiopulmonary bypass and reconstruction of the arch vessels, was anastomosed onto the right side of the ascending aorta. The 3 arch vessels were then bypassed sequentially during systemic cooling and monitoring cerebral perfusion with near-infrared oxymetry. After aortic cross-clamping, a stent graft was inserted into the distal arch from the distal ascending aorta, maintaining cerebral and cardiac perfusion. This procedure is indicated especially in a high-risk patient who has an aortic arch aneurysm without severe atheromatous change in the ascending aorta and the arch vessels.

Key words

stent graft aortic arch aneurysm near-infrared oxymetry ischemia 

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References

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Copyright information

© The Japanese Society of Thoracic and Cardiovascular Surgery 2002

Authors and Affiliations

  • Junichi Naganuma
    • 1
  • Mikio Ninomiya
    • 1
  • Takeshi Miyairi
    • 1
  • Yutaka Kotsuka
    • 1
  • Shinichi Takamoto
    • 1
  1. 1.Department of Cardiothoracic Surgery Graduate School of MedicineUniversity of TokyoTokyoJapan

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