Surgical treatment of an aortic arch aneurysm: reports of 2 cases with lesion of the arch vessels
Tayama, K.; Akashi, H.; Fujino, T.; Okazaki, T.; Aoyagi, S.
Kyobu Geka. Japanese Journal of Thoracic Surgery 51(13): 1074-1079
1998
ISSN/ISBN: 0021-5252 PMID: 9866337 Document Number: 490350
<Case 1> A 48-year old woman underwent surgery for an aortic arch aneurysm with stenosis or dilatation of three arch vessels caused by aortitis syndrome. Total arch replacement and reconstruction of three arch vessels were performed with hypothermic selective cerebral perfusion (SCP). To avoid atheroembolism and malperfusion to the brain, the rt. common carotid artery was perfused via the rt. subclavian artery through the dacron vascular graft and the lt. subclavian artery was cannulated and perfused distally to stenosis. <Cases 2> A 65-year-old man who had an atherosclerotic aortic arch aneurysm with severe stenosis of the brachiocephalic artery underwent operation. In the operation, extracorporeal circulation was instituted with the arterial return through the lt. subclavian artery. Same as case 1, total arch replacement and reconstruction of three arch vessels were performed under hypthermic SCP. In this case, the left common carotid artery was transected and cannulated directly into the vessel, instead of cannulation through the aortic lumen because of atheromatous plaques in the orifice of the left common carotid artery. The patients recovered uneventfully and doing well now.