Document Detail


Clot formation between the folded graft layers in the reversed elephant trunk technique at the second stage of total arch replacement.
MedLine Citation:
PMID:  17444168     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We operated on a 77-year-old woman with extensive thoracic aortic aneurysm by staged repair using the reversed elephant trunk technique. First, we performed descending aortic replacement with a 28-mm straight Dacron graft through a left lateral thoracotomy. Considering the high possibility of a proximal operation in the near future, the 10-cm invaginated proximal end of the graft was anastomosed to the aorta to facilitate subsequent operation on the upstream aorta. After a year of follow-up, a second-stage total arch replacement was performed because the aortic arch aneurysm had enlarged. The reversed elephant trunk was withdrawn under deep hypothermic circulatory arrest. Fibrin clots had formed within the folded graft, which could cause postoperative thromboembolism. After cleaning the inner surface of the withdrawn graft, the proximal branched conduit was anastomosed to it to complete the total arch replacement. We review this case and discuss possible mechanisms of and solutions for this condition.
Authors:
Mitsuaki Matsumoto; Kotaro Suehiro; Hiroshi Kubo
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  General thoracic and cardiovascular surgery     Volume:  55     ISSN:  1863-6705     ISO Abbreviation:  -     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-04-20     Completed Date:  2007-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101303952     Medline TA:  Gen Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  23-5     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan. vivaldi@fa2.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical
Aneurysm, Dissecting / surgery
Aortic Aneurysm, Abdominal / surgery*
Aortic Aneurysm, Thoracic / surgery*
Blood Vessel Prosthesis Implantation / adverse effects*,  instrumentation
Circulatory Arrest, Deep Hypothermia Induced
Female
Humans
Reoperation
Thoracotomy
Thrombosis / etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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