Hybrid Technique for Extensive Aortic Arch Aneurysm after Thoracoabdominal Aortic Aneurysm Repair

  • Takinami Gaku
    Department of Cardiovascular Surgery, Southern Tohoku General Hospital
  • Midorikawa Hirofumi
    Department of Cardiovascular Surgery, Southern Tohoku General Hospital
  • Ueno Kyohei
    Department of Cardiovascular Surgery, Southern Tohoku General Hospital
  • Kageyama Rie
    Department of Cardiovascular Surgery, Southern Tohoku General Hospital
  • Kanno Megumu
    Department of Cardiovascular Surgery, Southern Tohoku General Hospital

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  • 胸腹部大動脈置換術後の広範囲弓部大動脈瘤に対する分割ハイブリッド手術の1例

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<p>We report a case of operations using a hybrid technique for repeated extensive aortic aneurysm. A 71-year-old man had extensives aneurysms of the aortic arch and descending aorta. In the first operation, he had undergone thoracoabdominal aortic replacement with island repair for thoracoabdominal aortic aneurysm (Crawford type 3) at age 64. Six years later, computed tomography showed an aortic aneurysm around the region of the island repair and penetrating atherosclerotic ulcer (PAU). Therefore, he underwent abdominal debranching and thoracic endovascular aortic repair (TEVAR) at 70 years old. At the same time, he had an extensive aortic arch aneurysm. Considering the complicated surgical history and the affected region, we judged that conventional graft replacement was difficult. So, in the third operation, we performed TEVAR for the descending aorta at 71 years old. One month later, total arch replacement (TAR) with a frozen elephant trunk (FET) was performed (4th operation). The patient was discharged home 22 days after the 4th operation. This strategy of operations using hybrid techniques for extensive aortic aneurysm may be useful in high risk cases of surgical procedures and postoperative complications.</p>

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