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Ann Thorac Surg 2000;70:1974-1976
© 2000 The Society of Thoracic Surgeons

Original article: cardiovascular

Distal arch aneurysm repair using stent-grafting and ascending aorto-left axillary bypass

Yukinori Moriyama, MDa, Yoshifumi Iguro, MDa, Koichi Hisatomi, MDa, Riichiro Toda, MDa, Goichi Yotsumoto, MDa

a Second Department of Surgery, Kagoshima University, Faculty of Medicine, Kagoshima, Japan

Accepted for publication May 12, 2000.

Address reprint requests to Dr Moriyama, Division of Cardiovascular Surgery, National Takasaki Hospital, Takamatsu-cho 36, Gunma, Japan
e-mail: moriyamy{at}takasaki.hosp.go.jp

Background. Transcatheter application of a stent-graft to the angulated aortic segments with critical side branches poses some problems. We report our technique of distal arch aneurysm repairs using stent-grafts inserted through the aortic arch and ascending aorto-axillary bypass.

Patients and Results. Three patients underwent successful distal arch aneurysm repair using a homemade semiflexible stent-graft placed under hypothermic circulatory arrest. The left subclavian artery was reconstructed by an extraanatomic bypass grafting between the ascending aorta and left axillary artery. Postoperative imaging demonstrated reduction of aneurysm size and no endoleaks from an intercostal artery.

Conclusions. Our technique seems to be useful for repair of distal arch aneurysms and is a less invasive procedure.






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