Abstract
An anastomotic aneurysm of the ascending aorta occurred as a complication 21 years after shunt operation from the ascending aorta to the bilateral carotid arteries with a Y-shaped graft to repair pulseless disease due to aortitis syndrome. Since the aneurysm invaded the sternum and brain circulation was maintained only by collateral vessels from the aorta, massive bleeding at thoracotomy and brain ischemia during operation were anticipated. Therefore, femorofemoral extracorporeal circulation was started before thoracotomy to prevent bleeding, and in order to maintain collateral circulation to the brain, only aneurysmectomy was done through midsternotomy. The patient was saved without brain damage by this procedure.
