A Case of Staged Hybrid Repair for Subacute Type B Aortic Dissection in a Patient with Shaggy Aorta
- VernacularTitle:Shaggy aorta を伴う解離性大動脈瘤に対する二期的ハイブリッド治療を施行した1例
- Author:
Toshitaka WATANABE
1
;
Nobuyuki YOSHITANI
1
;
Ryo TOHMA
1
;
Takuya MISATO
1
;
Kazuma OKAMOTO
1
;
Taro HAYASHI
1
;
Satoshi TOBE
1
Author Information
- Keywords: frozen elephant trunk; thoracic endovascular aortic repair (TEVAR); shaggy aorta; total arch replacement; Type B aortic dissection
- From:Japanese Journal of Cardiovascular Surgery 2021;50(1):44-48
- CountryJapan
- Language:Japanese
- Abstract: In aortic surgery involving shaggy aorta, surgical strategy to avoid embolism is crucial for each case. We applied the frozen elephant trunk technique to a patient with shaggy aorta. A 79-year-old man was admitted to our hospital for conservative treatment of acute Type B aortic dissection. Dissecting aneurysms of the aortic arch and descending aorta were shown to have rapidly dilated according to CT three weeks later. Preoperative contrast CT showed an ulcerated shaggy aorta from the aortic arch to the mid portion of the descending aorta. To utilize the benefit of the stent compared with the classical elephant trunk technique, we proposed that the frozen elephant trunk technique would be helpful in prevention of embolism. We therefore planned total arch replacement with the frozen elephant trunk technique and performed thoracic endovascular aortic repair. We employed the frozen elephant trunk technique in the first operation and balloon protection of the superior mesenteric artery and the renal artery in the second operation. The patient had an uneventful postoperative course without thromboembolism. The frozen elephant trunk technique may be helpful for patients with shaggy aorta to avoid thromboembolic events.
