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Ann Thorac Surg 2003;76:1298-1301
© 2003 The Society of Thoracic Surgeons

Case report

Preoperative construction of an extracranial arterial shunt for resection of an aortic arch aneurysm with occluded left carotid artery

Hisato Takagi, MD, PhDa*, Yoshio Mori, MD, PhDa, Yukio Umeda, MD, PhDa, Yukiomi Fukumoto, MD, PhDa, Yoshimasa Mizuno, MDa, Yasuhiko Kaku, MD, PhDb, Noboru Sakai, MD, PhDb, Hajime Hirose, MD, PhDa

a First Department of Surgery, Gifu University School of Medicine, Gifu Japan
b Department of Neurosurgery, Gifu University School of Medicine, Gifu, Japan

Accepted for publication February 21, 2003.

* Address reprint requests to Dr Takagi, First Department of Surgery, Gifu University School of Medicine, 40 Tsukasa, Gifu 500-8705, Japan
e-mail: h-takagi{at}cc.gifu-u.ac.jp

A 68-year-old man with aortic arch aneurysm was referred to our department. Preoperative carotid echography and magnetic resonance angiography revealed occlusion of the left internal carotid artery. Single-photon emission computed tomography scanning indicated that cerebral blood flow was decreased and reactivity to acetazolamide was reduced in the left temporal lobe. A successful superficial temporal artery–middle cerebral artery anastomosis was first made by neurosurgeons. A postoperative single-photon emission computed tomography scan showed that cerebral blood flow and reactivity to acetazolamide were remarkably improved. Two months after the anastomosis, the aortic arch aneurysm was successfully repaired.






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