Annals of Thoracic and Cardiovascular Surgery
Online ISSN : 2186-1005
Print ISSN : 1341-1098
ISSN-L : 1341-1098
Total Aortic Arch Replacement after Thoracic Endovascular Aortic Repair Using Left Subclavian Arterial Perfusion
Taijiro SuedaShinya TakahashiKeijiro Katayama
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JOURNALS OPEN ACCESS Advance online publication

Article ID: cr.18-00001

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Abstract

We present the case of an 86-year-old male with an aortic arch saccular aneurysm who underwent zone 1 thoracic endovascular aortic repair (TEVAR) with debranching from the right subclavian artery to the left carotid and left subclavian arteries. The patient developed a type Ia endoleak 1 month later. Postoperative contrast computed tomography (CT) showed a hematoma around the aneurysm, concerning for impending rupture. He thus underwent emergency endograft removal and replacement with a one-branched graft using selective cerebral perfusion via the left subclavian artery perfusion. The left subclavian artery was used for systemic and cerebral perfusion without need for cannulation of the cervical arteries. The patient was successfully discharged 6 months after surgery.

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© 2018 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

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