Endovascular Total Arch Repair Using In Situ Fenestration for Arch Aneurysm and Chronic Type A Dissection Yoshiaki Katada, MD, PhD, Shunichi Kondo, MD,

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Presentation transcript:

Endovascular Total Arch Repair Using In Situ Fenestration for Arch Aneurysm and Chronic Type A Dissection Yoshiaki Katada, MD, PhD, Shunichi Kondo, MD, PhD, Eitoshi Tsuboi, MD, PhD, Kyu Rokkaku, MD, PhD, Yoshihito Irie, MD, PhD, Hitoshi Yokoyama, MD, PhD The Annals of Thoracic Surgery Volume 101, Issue 2, Pages 625-630 (February 2016) DOI: 10.1016/j.athoracsur.2015.07.032 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Details of cardiopulmonary bypass system. The main circuit was reserved as a spare circuit for open conversion, and one of the selective cerebral perfusion circuits was also reserved for left common carotid artery (LCCA) perfusion if transposition was to be performed. (Lt = left; Rt = right.) The Annals of Thoracic Surgery 2016 101, 625-630DOI: (10.1016/j.athoracsur.2015.07.032) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Intraoperative digital subtraction angiogram before stent deployment clearly shows a type A aortic dissection. (B) Completion angiogram after endo-total arch repair with the use of in situ fenestration does not show any endoleaks and provides a good visualization of all the arch branches. The Annals of Thoracic Surgery 2016 101, 625-630DOI: (10.1016/j.athoracsur.2015.07.032) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Contrast-enhanced computed tomographic image obtained before the procedure. (A) Three-dimensional volume-rendered reconstruction and (B) the original axial image show a type A aortic dissection and the placement of the entry hole in the ascending aorta. The Annals of Thoracic Surgery 2016 101, 625-630DOI: (10.1016/j.athoracsur.2015.07.032) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Contrast-enhanced computed tomographic image obtained 18 months after the procedure. (A) Three-dimensional volume-rendered reconstruction and (B) the original axial image clearly show complete coagulation and the remarkable shrinkage of the thrombosed false lumen. The Annals of Thoracic Surgery 2016 101, 625-630DOI: (10.1016/j.athoracsur.2015.07.032) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions