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Total Arch Replacement with Concomitant Thoracic Endovascular Aortic Repair Via the Ascending Aorta for Extended Thoracic Aneurysm;Report of a Case Yoshiki Endo 1 , Yoshihito Irie 1 , Kousuke Nishida 1 , Tsuyoshi Fujimiya 1 , Yoshiaki Katada 1 1Department of Cardiovascular Surgery, Iwaki Kyouritsu General Hospital Keyword: TEVAR (thoracic endovascular aortic repair) , type B chronic aortic dissection , total arch replacement (TAR) , patent ductus arteriosus (PDA) pp.347-350
Published Date 2018/5/1
DOI https://doi.org/10.15106/j_kyobu71_347
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The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus (PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia. After establishment of cardiopulmonary bypass (CPB), a stent graft was inserted via the ascending aorta to cover the dissection site of descending aorta, the aorta was opened under circulatory arrest, and PDA was suture closed. Another stent graft whose two proximal rows of Z-stent was removed, was inserted to descending aorta via the ascending aorta landing on the previous stent graft. The proximal end of this stent graft was anastomosed to the distal end of the prosthetic arch graft and arch branches were reconstructed as usual. The postoperative course was uneventful.


© Nankodo Co., Ltd., 2018

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電子版ISSN 2432-9436 印刷版ISSN 0021-5252 南江堂

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