Ascending Aorta and Total Arch Replacement in a Stanford Type A Aortic Dissection with Island Reconstruction for an Isolated Left Vertebral Artery
10.4326/jjcvs.39.318
- VernacularTitle:左椎骨動脈大動脈起始を伴う大動脈解離に対して別個の1本グラフトで弓部分枝を島状再建した上行弓部置換術の1例
- Author:
Narihiro Ishida
;
Katsuya Shimabukuro
;
Yukihiro Matsuno
;
Hirofumi Takemura
- Publication Type:Journal Article
- Keywords:
arch vessel anomalies;
isolated left vertebral artery;
total arch replacement
- From:Japanese Journal of Cardiovascular Surgery
2010;39(6):318-320
- CountryJapan
- Language:Japanese
-
Abstract:
The ascending aorta and aortic arch were replaced in a 72-year-old woman with Stanford type A aortic dissection. Preoperative three-dimensional computed tomography (3D-CT) revealed that the anatomy of an isolated left vertebral artery was abnormal. After hypothermic circulatory arrest, a 12-mm sealed graft was connected to the island-shaped arch under retrograde cerebral perfusion, followed by antegrade cerebral perfusion via a branch of the graft. The main graft was distally anastomosed, and the graft of the cerebral arteries was subsequently anastomosed on the main graft under continuous cerebral and systemic perfusion. The patient tolerated all procedures well without cerebral or bleeding complications, and was discharged 18 days after surgery. This technique was useful for island reconstruction, even with abnormal cerebral arteries and bleeding control of this anastomosis was simple compared to the conventional island technique.
