Hybrid Repair of an Aortic Arch Aneurysm Using Double Parallel Grafts Perfused by Retrograde Flow in Endovascular Repair Combined With Left Subclavian.

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A new staged hybrid total arch repair procedure using a branched proximal elephant trunk technique with implantation of stent grafts to the ascending.

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Hybrid Repair of an Aortic Arch Aneurysm Using Double Parallel Grafts Perfused by Retrograde Flow in Endovascular Repair Combined With Left Subclavian Artery Surgical Bypass Gao Feng, MD, Zeng Qian, MD, Guan Jun, MD, Lin Fangming, MD The Annals of Thoracic Surgery Volume 100, Issue 5, Pages 1888-1891 (November 2015) DOI: 10.1016/j.athoracsur.2014.12.089 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Computed tomography (CT) scan showing three aneurysms located at the aortic arch and the descending aorta. The patient’s ascending aorta was normal, with a diameter of approximately 40 mm and a bovine arch. The arch aneurysm was measured at 5.5 cm in diameter in the sagittal direction, and there were two thoracic descending aorta aneurysms with diameters of 4.6 and 5.3 cm, respectively. (B) Angiography showing the cross-section of aortic arch in the right anterior oblique position before the deployment of parallel grafts. (C) Final angiography showing that all the grafts and bypass were patent and in good position. (D) CT image showing that all stent grafts are in good shape and position at 7-month follow-up. (E) A 7-month follow-up CT scan revealed that each stent graft was patent. The asterisks (*) reveal the range of the graft (34 × 30 × 160 mm) in the ascending aorta and proximal arch; the numbers signs (#) reveal the range of the graft (36 × 30 × 180 mm) in the distal arch and descending aorta. (F) A 7-month follow-up CT scan showing that the stent graft in the ascending aorta had a lumen of 34 × 22 mm and good blood flow. (GSV = great saphenous vein; IA = innominate artery; LCCA = left common carotid artery; LSA = left subclavian artery.) The Annals of Thoracic Surgery 2015 100, 1888-1891DOI: (10.1016/j.athoracsur.2014.12.089) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions