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Ann Thorac Surg 2002;74:2186-2189
© 2002 The Society of Thoracic Surgeons

Case report

Open surgical intervention to recurrent aortic dissection after endovascular stent grafting

Masato Machii, MDa*, Kuniyoshi Ohara, MDa, Hiroshi Imai, MDa, Zong Bo Lin, MDa, Kyouichi Sudo, MDa, Hirokuni Yoshimura, MDa

a Department of Thoracic and Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

Accepted for publication July 10, 2002.

* Address reprint requests to Dr Machii, Department of Thoracic and Cardiovascular Surgery, Kitasato University School of Medicine, 1-15-1, Kitasato, Sagamihara, Kanagawa 228-8555, Japan.
e-mail: machii{at}med.kitasato-u.ac.jp

We report the case of a 49-year-old man who received open-heart surgery for recurrent aortic dissection after endovascular stent grafting. Stent grafting had been successfully performed in the acute phase. Recurrent dissection became obvious 5 months later, and at the same time, aneurysmal change was detected between the left subclavian artery and the proximal end of the stent graft. We employed a "Y arch" surgical procedure and "elephant trunk" technique to treat, and the entry tear was completely sealed and the aneurysm was excluded by elephant trunk segment. We believe that this approach could be a new option for treatment for complicated aortic aneurysms.






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