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Endovascular Repair of a Right-Sided Descending Thoracic Aortic Aneurysm With a Right-Sided Aortic Arch and Aberrant Left Subclavian Artery  Joseph J.

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Presentation on theme: "Endovascular Repair of a Right-Sided Descending Thoracic Aortic Aneurysm With a Right-Sided Aortic Arch and Aberrant Left Subclavian Artery  Joseph J."— Presentation transcript:

1 Endovascular Repair of a Right-Sided Descending Thoracic Aortic Aneurysm With a Right-Sided Aortic Arch and Aberrant Left Subclavian Artery  Joseph J. Naoum, MD, Jennifer L. Parenti, RN, Scott A. LeMaire, MD, Joseph S. Coselli, MD  The Annals of Thoracic Surgery  Volume 85, Issue 3, Pages (March 2008) DOI: /j.athoracsur Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Drawings and (B, C, D) arteriograms of the patient’s right-sided aortic arch, right-sided descending thoracic aortic aneurysm, and aberrant left subclavian artery. (B) Right anterior oblique (RAO) projection showing the right and left common carotid arteries arising from a common trunk. The right vertebral artery is dominant. (C) An RAO projection showing a left subclavian artery arising from a Kommerell’s diverticulum, which is particularly evident in the inset (arrow). The left vertebral artery is small. (D) A left anterior oblique view demonstrates the landing zone target immediately distal to where the right subclavian artery originates from the aorta. (a = artery; L = left; R = right.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Arteriogram showing a patent left carotid to subclavian artery bypass. No flow is visible in the proximal left subclavian artery, confirming its proximal ligation. (L = left.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Illustration of the completed repair, including left carotid to subclavian bypass and endovascular exclusion of the aortic aneurysm. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Intraoperative arteriogram obtained after the endovascular repair was completed. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

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