Document Detail


Thoracic endograft positioning and carotid-subclavian bypass grafting in a patient with a saccular aneurysm at the aortic arch.
MedLine Citation:
PMID:  17714639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 75-year-old man was referred to our hospital because of sudden thoracic pain. A saccular aneurysm of the aortic arch extending on the anterior surface of the aortic arch was found on computed tomographic arteriography. The patient was hemodynamically stable and he was programmed for a staged surgical and endovascular approach (hybrid approach). As a first stage and in order to prevent major cardiac complications due to the overstenting of the left subclavian artery (LSA) with the occlusion of the aortocoronary bypass, the patient underwent a polytetrafluoroethylene bypass graft (GORE-TEX, W.L. Gore & Associates, Flagstaff, AZ) between the LSA and the left carotid artery. Intraoperative arteriography revealed a good patency of the left carotid-subclavian bypass and of the left internal mammary bypass on the left anterior descending artery. As a second stage the endovascular procedure was accomplished 5 days later in the operating room. A Gore TAG stent graft (W.L. Gore & Associates) was deployed in the aortic arch 20 mm proximally to the aneurysmatic segment covering the ostium of the LSA. The postoperative course was uneventful and the patient was discharged on the fifth postoperative day in good general conditions. Hybrid procedures for treatment of aneurysms of the aortic arch or of the descending thoracic aorta are a promising alternative to open surgery especially in high-risk patients, with lower early morbidity and mortality rates. Long-term effectiveness remains to be fully elucidated.
Authors:
Nicolas Valerio; Federico Bucci; Adriano Redler; Bruno Salvati; Michel Ferdani
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Vascular     Volume:  15     ISSN:  1708-5381     ISO Abbreviation:  Vascular     Publication Date:    2007 Jul-Aug
Date Detail:
Created Date:  2007-08-23     Completed Date:  2008-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101196722     Medline TA:  Vascular     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  221-5     Citation Subset:  IM    
Affiliation:
Department of Cardio-Vascular Surgery, St. Joseph Hospital, Marseille, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography, Digital Subtraction
Aortic Aneurysm, Thoracic / radiography,  surgery*
Blood Vessel Prosthesis Implantation / methods*
Carotid Arteries / surgery*
Humans
Male
Subclavian Artery / surgery*
Surgical Procedures, Minimally Invasive / methods
Tomography, X-Ray Computed

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


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