Transposition of the left carotid artery to the ascending aorta to repair aortic arch injury

Abstract   We present a case where we repaired the aortic arch, by the transposition of the left carotid artery to the ascending aorta. A 52-year-old man presented to our department with a penetrating chest wound by a gunshot in the attempt of suicide. The aortic arch and the insertion of the left carotid artery were involved in the lesion. Through sternotomic approach, the aortic arch was repaired in extracorporeal circulation. Left carotid artery was transected to allow easier repair of the arch posterior wall involved in the lesion, and to reduce the danger of residual stenosis. Then, it was translocated to the ascending aorta by interposing a 7-mm Gore-Tex (W.L. Gore & Associates, Flagstaff, AZ, USA) conduit. The patient complicated renal failure and pneumonia in the postoperative period, but eventually he was discharged in good general conditions.