Masato Machii, MD, Kuniyoshi Ohara, MD, Hiroshi Imai, MD, Zong B

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Presentation transcript:

Open surgical intervention to recurrent aortic dissection after endovascular stent grafting Masato Machii, MD, Kuniyoshi Ohara, MD, Hiroshi Imai, MD, Zong B.o Lin, MD, Kyouichi Sudo, MD, Hirokuni Yoshimura, MD The Annals of Thoracic Surgery Volume 74, Issue 6, Pages 2186-2189 (December 2002) DOI: 10.1016/S0003-4975(02)04107-3

Fig 1 Aortography performed before (A) and after (B) stent grafting. Primary entry detected 4 cm below the left subclavian artery (arrow). (C) Aortography performed 5 months after stent grafting. Aortic protrusion (asterisk) between the left subclavian artery and opacification of false lumen (arrow) were identified. Entry tear was detected at the site of the proximal end of the stent graft. (D) Intravenous digital subtraction angiography after surgical intervention revealed exclusion of aortic protrusion and obliteration of false lumen with elephant trunk segment. All neck arteries were reconstructed with a Y arch. The Annals of Thoracic Surgery 2002 74, 2186-2189DOI: (10.1016/S0003-4975(02)04107-3)

Fig 2 Operative procedures. (A) Aortic “island” was sewn to the beveled end of 16-mm vascular graft. (B) After completion of anastomosis, the brachiocephalic artery and the left common carotid artery were perfused antegradely via side branch of 16-mm vascular graft. (C) Invaginated 26-mm vascular graft was inserted into the transected aorta. (D) Doubled-up ridge of inserted vascular graft was aligned to the edge of the transected aorta and a full-thickness suture was performed. (E) Repair complete. The Annals of Thoracic Surgery 2002 74, 2186-2189DOI: (10.1016/S0003-4975(02)04107-3)