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A Complex Thoracoabdominal Aneurysm in a Loeys-Dietz Patient: An Open, Hybrid, Anatomic Repair  Eugenio Neri, MD, Giulio Tommasino, MD, Enrico Tucci,

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Presentation on theme: "A Complex Thoracoabdominal Aneurysm in a Loeys-Dietz Patient: An Open, Hybrid, Anatomic Repair  Eugenio Neri, MD, Giulio Tommasino, MD, Enrico Tucci,"— Presentation transcript:

1 A Complex Thoracoabdominal Aneurysm in a Loeys-Dietz Patient: An Open, Hybrid, Anatomic Repair 
Eugenio Neri, MD, Giulio Tommasino, MD, Enrico Tucci, MD, Antonio Benvenuti, MD, Carmelo Ricci, MD  The Annals of Thoracic Surgery  Volume 90, Issue 6, Pages e88-e90 (December 2010) DOI: /j.athoracsur Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 A preoperative computed tomography scan shows the descending aorta with multiple stent grafts. (A) Proximally, thoracic endovascular aneurysm repair promoted effective false channel thrombosis. (C) In the distal thoracic aorta, the stent graft crosses the true channel, redirecting the blood flow into the false channel, which is extremely dilated. (B) A severe pectus excavatum with leftward heart rotation made the surgical exposure of the descending aorta very complex. The Annals of Thoracic Surgery  , e88-e90DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 This diagram illustrates the surgical tool designed to obtain the in vivo crimping of the thoracic stent graft already in place. The tool consists of (A) a 10-mm stainless steel tube and (B) a trumpet-shaped funnel (50-mm diameter) capable of being split and disengaged from the tube once the graft is loaded and crimped. The parts are kept together by a heavy silk suture. (C) The thoracic stent graft contained inside of the tube could be passed and released inside of a branched Siena collared graft, thus obtaining continuity between the surgical and the endovascular grafts. The Annals of Thoracic Surgery  , e88-e90DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 A postoperative computed tomography scan shows the hybrid repair of the thoracoabdominal aorta. The hybrid junction is confined inside the excluded aneurysm by suturing the graft collar to the aortic aneurysm (white arrow). No distortion or fracture of the metal structure of thoracic stent graft was observed after cross clamping. The Annals of Thoracic Surgery  , e88-e90DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

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