Surgical treatment of an aneurysm involving ascending aorta, aortic arch, and a rupture of a descending aortic aneurysm 26 years following acute type.

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Presentation transcript:

Surgical treatment of an aneurysm involving ascending aorta, aortic arch, and a rupture of a descending aortic aneurysm 26 years following acute type A aortic dissection Christian Kühn, MD, Omke E. Teebken, MD, Jürgen Weidemann, MD, Matthias Karck, MD, Maximillian Pichlmaier, MD, Axel Haverich, MD The Journal of Thoracic and Cardiovascular Surgery Volume 131, Issue 1, Pages 235-236.e1 (January 2006) DOI: 10.1016/j.jtcvs.2005.08.055 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Preoperative computed tomography scan showing the complex aortic dissection involving arch (a), descending (b), thoraco-abdominal (c) and perirenal (d) aorta. The coloured reconstruction shows (e) the various lumens, however, the contained rupture is only apparent in (c). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 235-236.e1DOI: (10.1016/j.jtcvs.2005.08.055) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Postoperative computed tomography scan after replacement of the entire aorta including the distal ascending aorta (b), aortic arch (a), descending (b, c) and the thoraco-abdominal (d) aorta; oblique reformation (e) and coloured reconstruction (f). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 235-236.e1DOI: (10.1016/j.jtcvs.2005.08.055) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Intraoperative situs. The aortic arch was dissected (a), opened and selective cerebral perfusion was established via balloon tipped catheter in the brachiocephalic trunk and the left carotid artery (b). Following the proximal anastomosis between the old ascending aortic graft and the new prosthesis (c), the brachiocephalic trunk and the left carotid artery were reinserted as an island cuff. Retrograde perfusion of the upper body was reestablished via cannulation of the prosthesis (d). The complex dissection, the severity of calcifications and the contained rupture (area above the suction device) are shown in (e). During the distal anastomosis, abdominal organ perfusion was secured via balloon tipped catheters in the celiac trunk and superior mesenteric artery (f). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 235-236.e1DOI: (10.1016/j.jtcvs.2005.08.055) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions