Innovative hybrid procedure for dissection thoracic aorta in a patient with a previous bentall operation.
Indian Heart J
;
2008 Jan-Feb; 60(1): 61-3
Artigo
em Inglês
| IMSEAR
| ID: sea-2902
ABSTRACT
AIMS AND OBJECTIVES:
In dissection aorta involving the whole aorta from the left subclavian artery surgical repair may be a high risk procedure while an endovascular procedure would not be feasible by itself in view of the absence of a safe landing zone and the risk of blocking the brain and arm circulation. A hybrid procedure is presented to tackle such a problem.METHODS:
A 42-year-old Marfan, with a previous history of a Bentall procedure 10 years back, presented with acute thoracic aortic dissection. Investigations revealed a large dissection starting from the left subclavian to the right renal artery. Since a safe landing zone was required which would block off the arch vessels, first a redo sternotomy was performed and under femoro-femoral cardio-pulmonary bypass (CPB), a short segment of Dacron graft was interposed between the previous Bentall graft and the arch of aorta. On to this graft, 2 additional grafts were anastomosed. A 14 X 9 bifurcated graft to go to the right brachiocephalic and the left common carotid, and a 9 mm side arm to facilitate the positioning of the endograft. After coming off CPB, a guide wire was manipulated from the femoral artery into the side graft with a snare and the endograft was inserted.RESULTS:
The false lumen was successfully obliterated. The patient made a complete recovery with no neurological deficit.CONCLUSIONS:
A hybrid procedure with an innovative technique of preserving the brain and arm circulation and a new technique of facilitating proper positioning of the endostent with a side arm conduit is presented.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Aorta Torácica
/
Ruptura Aórtica
/
Reoperação
/
Humanos
/
Masculino
/
Angioplastia
/
Adulto
/
Implante de Prótese Vascular
/
Síndrome de Marfan
Idioma:
Inglês
Revista:
Indian heart j
Ano de publicação:
2008
Tipo de documento:
Artigo
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