共查询到20条相似文献,搜索用时 15 毫秒
1.
H Kurata S Satoh M Kohno H Kajiwara Y Mashimo H Satoh 《[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai》1989,37(1):171-174
A 44-year-old man was admitted to our hospital with complaint of weakness in his left upper extremity, vertigo, and diplopia. After aortic root injection of contrast medium, a right aortic arch was visualized. The left brachiocephalic artery was not found, however. An operation was performed through a midline sternotomy. The first branch of the aortic arch was the right common carotid artery, and the second branch was the right subclavian artery. The left brachiocephalic arterial aplasia was recognized. An E-PTFE graft was anastomosed proximally to the ascending aorta and distally to the junction of the left common carotid and left subclavian arteries. After the operation, some of the symptoms were improved and the others were removed. 相似文献
2.
A 4-month-old boy was referred for persistent respiratory symptoms despite having undergone division of the ligamentum arteriosus for the diagnosis of a right aortic arch with an aberrant left subclavian artery. A computed tomography scan demonstrated symmetric arch vessels around the trachea at the thoracic inlet, with the left common carotid artery being tethered posteriorly, more suggestive of a double aortic arch with an atretic left arch between the left common carotid and subclavian arteries. This diagnosis was confirmed intraoperatively, and division of the atretic portion released the bronchial obstruction. This case highlights the importance of careful evaluation of the vascular anatomy. 相似文献
3.
Information about the variations of the origins of subclavian and vertebral arteries and their course is of great importance for head and neck surgery. The normal vertebral arteries arise as the first branches of the corresponding subclavian arteries. In a minority of cases, the left vertebral artery could arise directly from the aortic arch between the left common carotid and the left subclavian arteries. An aberrant right subclavian artery arising as the last branch of the aortic arch is also a frequently seen aortic arch anomaly. Here, we present a case with common trunks of the subclavian and vertebral arteries, demonstrated by cardiac catheterization. 相似文献
4.
Anomalous Origins of the right vertebral, subclavian, and common carotid arteries in a patient with a four-vessel aortic arch 总被引:1,自引:0,他引:1
Many anomalies of the aortic arch and great vessels are uncovered as serendipitous findings on imaging studies, in the anatomy
laboratory, or at surgery. A 56-year-old man had an arch angiogram as part of an evaluation for cerebrovascular disease. A
four-vessel left aortic arch was identified consisting of the right carotid, left carotid, right subclavian, and left subclavian
arteries. The right common carotid gave rise to the right vertebral artery in the chest while the normally located left vertebral
arose from the left subclavian artery. No aneurysm or aortic diverticulum was identified. 相似文献
5.
Manabu Noguchi Ryuichiro Shibata Miyoko Iwamatsu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》1991,51(7):314-317
Cervical aortic arch is an unusual malformation. Cervical aortic arch with aneurysm formation is very rare. We report a case
of cervical aortic arch associated with a saccular aneurysm in a 59-year-old Japanese man. The aneurysm protruded caudally
and was located between the left common carotid and left subclavian arteries. Cardiopulmonary bypass and deep hypothermic
circulatory arrest was applied as adjunct methods. A Dacron graft was sutured just distal to the left common carotid artery,
with the patient in the Trendelenburg position. The proximal site was left open while oxygen-saturated venous blood was supplied
in a retrograde manner to perfuse the lower body during occlusion of the descending aorta. Distal anastomosis to the descending
aorta was performed during rewarming. The left subclavian artery was reconstructed by using a branch of the graft. This procedure
is simple and useful for distal arch operations, especially in patients with Haughton D type aneurysms. 相似文献
6.
Manabu Noguchi Ryuichiro Shibata Miyoko Iwamatsu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(7):314-317
Cervical aortic arch is an unusual malformation. Cervical aortic arch with aneurysm formation is very rare. We report a case of cervical aortic arch associated with a saccular aneurysm in a 59-year-old Japanese man. The aneurysm protruded caudally and was located between the left common carotid and left subclavian arteries. Cardiopulmonary bypass and deep hypothermic circulatory arrest was applied as adjunct methods. A Dacron graft was sutured just distal to the left common carotid artery, with the patient in the Trendelenburg position. The proximal site was left open while oxygen-saturated venous blood was supplied in a retrograde manner to perfuse the lower body during occlusion of the descending aorta. Distal anastomosis to the descending aorta was performed during rewarming. The left subclavian artery was reconstructed by using a branch of the graft. This procedure is simple and useful for distal arch operations, especially in patients with Haughton D type aneurysms. 相似文献
7.
We report the case of a 28-year-old man who suffered a transection of the mid-transverse aortic arch between the innominate and left common carotid artery with complete avulsion of the left common carotid artery after blunt trauma. This patient underwent successful aortic arch replacement proximal to the left subclavian artery and reimplantation of the innominate and left carotid arteries using profound hypothermic circulatory arrest and selective antegrade cerebral perfusion. A literature review revealed no other previous reports of survival after this type of injury. 相似文献
8.
Ahluwalia GS Rashid AG Griselli M Szczeklik M Rigby ML Mohiaddin RH Shore DF 《The Annals of thoracic surgery》2007,84(3):1014-1016
We report the case of a 12-year-old boy with a hypoplastic retroesophageal circumflex right-sided cervical aortic arch and coarctation. After the incidental finding of a heart murmur when the boy was 9 years old, cardiac magnetic resonance showed a right-sided cervical aortic arch, hypoplastic transverse arch, and separate origin of the left common carotid, right common carotid, right vertebral, and right subclavian arteries. The left subclavian artery arose from the proximal descending aorta next to the coarctation. An extra-anatomical ascending to descending aorta tube graft was inserted through a right lateral thoracotomy with good results. 相似文献
9.
K Ueyama H Urayama H Takemura K Tsuchida A Kato Y Watanabe 《[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai》1992,40(8):1299-1303
The occurrence of coarctation in patients with right aortic arch is extremely rare. We have encountered a 21-year-old man with anomalous left subclavian artery. He was diagnosed when he was 13. On angiography he exhibited a right aortic arch. The left common carotid artery, right common carotid artery and the right subclavian artery diverged from the proximal side of the coarctation. The left subclavian artery diverged from the distal side. The right brachial arterial pressures measured 158-72 mmHg, while the left brachial arterial pressures measured 98-80 mmHg. Clinical studies revealed no vascular ring and no other anomalies were found in this patient. An attempt at treatment was made with extra anatomical bypass grafting from the ascending aorta to the descending aorta. No pressure difference due to coarctation remained after operation. 相似文献
10.
There is an increased risk of rupture with attempting a distal anastomosis when the distal aortic arch exceeds 5 to 6 cm. To circumvent this problem, we describe performing the anastomosis between the left common carotid and the left subclavian arteries and, at the second-stage operation, interposing a tube graft between the left subclavian artery and the descending aortic tube graft. 相似文献
11.
Coarctation of the aorta and interrupted aortic arch are not usually associated with stenosis of the innominate, common carotid, or subclavian arteries. We report two patients with stenoses of combinations of these arteries, one in association with coarctation (stented later in life) and the other in association with interrupted arch (arterial stenoses surgically repaired at the time of surgery for the arch proper). Both have done well. 相似文献
12.
目的:探讨累及主动脉弓部主动脉夹层手术方式选择及疗效。方法:收集2010年2月—2015年5月因主动脉弓部夹层在广州军区武汉总医院心胸外科接受手术治疗病例资料,分析其手术方式选择及理由,不同术式并发症发生率等。结果:检索出符合条件的病例92例,其中仅行胸主动脉腔内修复术(TEVAR)36例,预开窗血管支架的TEVAR 2例,封闭左锁骨下动脉的TEVAR 31例,不开胸主动脉弓分支血管旁路术+TEVAR17例(左颈总动脉-左锁骨下动脉旁路术4例,右颈总动脉-左颈总动脉-左锁骨下动脉旁路术3例,右颈总动脉-左颈总动脉术、封闭左锁骨下动脉10例),开胸主动脉弓置换术6例。2例开胸主动脉弓置换术患者术后死亡,其余术后无严重并发症发生。结论:对于累及主动脉弓部夹层,开胸主动脉弓置换术是一种成熟的治疗方式;TEVAR是的一种快速、有效、经济、术后并发症少的手术方式,并可以通过开窗、分支血管旁路术等方式扩大其应用范围。 相似文献
13.
14.
Sakamoto S Shibukawa M Tani I Araki O Oki S Kiura Y Okazaki T Kurisu K 《Acta neurochirurgica》2011,153(11):2169-2173
A right-sided aortic arch with an aberrant left subclavian artery is a rare anatomical variation. We report a case treated
with carotid artery stenting (CAS) for a patient with a right-sided aortic arch with an aberrant left subclavian artery. A
72-year-old man presented right hemiparesis due to acute brain infarction. Neck CT angiography showed 70% stenosis in the
left internal carotid artery (ICA). We diagnosed acute brain infarction as artery-to-artery embolism due to ICA stenosis and
decided to perform carotid artery stenting (CAS) for symptomatic ICA stenosis. CT angiography to evaluate an access route
to the lesion incidentally showed the right-sided aortic arch with an aberrant left subclavian artery. An intraoperative aortogram
showed a right-sided aortic arch. The guiding catheter was carefully introduced up to the left common carotid artery. CAS
was performed with a proximal balloon and distal filter protection. The stenotic area was restored, and the patient was discharged
without suffering recurrent attacks. Although a right-sided aortic arch with an aberrant left subclavian artery is a very
rare anatomical variation, it can be encountered in neuroendovascular treatment, and therefore knowledge of this anatomical
variation is important. 相似文献
15.
Yusuke Misumi Toru Kuratani Koichi Maeda Koichi Toda Shigeru Miyagawa Takayoshi Ueno Yoshiki Sawa 《Annals of thoracic and cardiovascular surgery》2021,27(4):264
Transcatheter aortic valve implantation (TAVI) through a peripheral arterial access is often complicated by concomitant arteriopathy. We describe here the first successful case of TAVI through the carotid artery in Japan. The patient was an 83-year-old woman with severe aortic stenosis (AS). Preoperative computed tomography (CT) revealed a shaggy distal aortic arch and left subclavian artery ostium, along with severely calcified bilateral iliofemoral arteries. Trans-apical and direct aortic approaches were abandoned because of frailty. Following the thorough cerebrovascular assessment, the left common carotid artery was selected for arterial access and a CoreValve transcatheter aortic valve was successfully implanted without neurologic complications. 相似文献
16.
George Matalanis Manoj Durairaj Mark Brooks 《European journal of cardio-thoracic surgery》2006,29(4):611-612
We describe a minimally invasive technique for complete aortic arch repair without cardiopulmonary bypass. A 77-year-old man with severe obstructive airways disease presented with aneurysmal disease of his aortic arch. Through a median sternotomy and the application of a side-biting clamp, the common trunk of a bifurcation Dacron graft was anastomosed to the ascending aorta. The limbs of the graft were anastomosed to the innominate and left common carotid arteries, respectively. The left subclavian artery was ligated. Two endoluminal stent grafts were deployed via a side arm in the Dacron graft, covering the whole arch. Completion angiography and transesophageal echocardiography revealed excellent seating of both stent grafts, with no endo-leaks. The patient had a rapid, uneventful post-operative recovery. Follow-up CT scanning revealed complete exclusion of the arch aneurysm. 相似文献
17.
目的:探讨体外开窗及开槽技术应用于胸主动脉腔内修复术(TEVAR)治疗主动脉弓部疾病的可行性。
方法:回顾性分析2016年9月—2019年4月23例体外开窗及开槽技术联合TEVAR术治疗主动脉弓部疾病患者的临床资料。
结果:23例患者中,覆膜支架近端放置Z0区3例,Z1区6例,Z2区14例。重建40条分支血管,包括无名动脉3条,左颈总动脉9条,左锁骨下动脉23条,迷走左椎动脉3条,迷走右锁骨下动脉2条;开槽技术重建15条,开窗技术25条。9条左锁骨下动脉被遮盖,技术成功率77.5%。31条分支血管术后通畅,随访中1条分支血管血栓形成,6条失访。4例(17.4%)内漏,2例随访中消失,1例减少。围手术期2例缺血性脑卒中(8.7%),1例死亡(4.3%),无截瘫发生。
结论:主动脉弓部疾病TEVAR治疗中应用体外开窗及开槽技术是可行、有效的方法。 相似文献
18.
Christopher Garcia Jorge Rey Alberto Lopez Joseph Lamelas Vicente Orozco‐Sevilla 《Journal of cardiac surgery》2019,34(10):1117-1119
Interrupted aortic arch (IAA) is defined as a discontinuity of the aortic lumen from the aortic arch to the descending aorta. The incidence of this congenital malformation is three per million live births. It represents about 1.5% of congenital cardiac abnormalities. The classification system for IAA is divided into three distinct categories—type A: interruption of the lumen distal to the left subclavian artery, occurring in 43% cases; type B: interruption between the left carotid and left subclavian arteries, occurring in 53% cases (the most common); and type C: interruption between the innominate and left carotid, occurring in 4% cases. We describe the case of a 47‐year‐old woman who had a symptomatic type A IAA. A single‐stage extra‐anatomic bypass was performed between the left subclavian and the descending thoracic aorta using a 14 mm Dacron graft. The use of this approach is an option to solve this challenging clinical problem. 相似文献
19.
Yukio Obitsu Nobusato Koizumi Toru Iwahashi Naozumi Saiki Hiroshi Shigematsu 《Journal of cardiothoracic surgery》2010,5(1):35
Aortic anomaly in which a right-sided aortic arch associated with Kommerell's diverticulum and aberrant left subclavian artery
is rare. The present report describes a patient with type-B aortic dissection accompanying aortic anomalies consisting of
right-sided aortic arch and the left common carotid and left subclavian artery arising from Kommerell's diverticulum. As dissecting
aortic aneurysm diameter increased rapidly, Single-stage surgical repair of extensive thoracic aorta was performed through
median sternotomy and right posterolateral fifth intercostal thoracotomy, yielding favorable results. Our surgical procedures
are discussed. 相似文献
20.
Baldwin ZK Chuter TA Hiramoto JS Reilly LM Schneider DB 《Annals of vascular surgery》2008,22(6):703-709
Thoracic endovascular aortic repair (TEVAR) may involve either planned or inadvertent coverage of aortic branch vessels when stent grafts are implanted into the aortic arch. Vital branch vessels may be preserved by surgical debranching techniques or by placement of additional stents to maintain vessel patency. We report our experience with a double-barrel stent technique used to maintain aortic arch branch vessel patency during TEVAR. Seven patients underwent TEVAR using the double-barrel technique, with placement of branch stents into the innominate (n = 3), left common carotid (n = 3), and left subclavian (n = 1) arteries alongside an aortic stent graft. Gore TAG endografts were used in all cases, and either self-expanding stents (n = 6) or balloon-expandable (n = 1) stents were utilized to maintain patency of the arch branch vessels. In three cases the double-barrel stent technique was used to restore patency of an inadvertently covered left common carotid artery. Four planned cases involved endograft deployment proximally into the ascending aorta with placement of an innominate artery stent (n = 3) and coverage of the left subclavian artery with placement of a subclavian artery stent (n = 1). TEVAR using a double-barrel stent was technically successful with maintenance of branch vessel patency and absence of type I endoleak in all seven cases. One case of zone 0 endograft placement with an innominate stent was complicated by a left hemispheric stroke that was attributed to a technical problem with the carotid-carotid bypass. On follow-up of 2-18 months, all double-barrel branch stents and aortic endografts remained patent without endoleak, migration, or loss of device integrity. The double-barrel stent technique maintains aortic branch patency and provides additional stent-graft fixation length during TEVAR to treat aneurysms involving the aortic arch. Moreover, the technique uses commercially available devices and permits complete aortic arch coverage (zone 0) without a sternotomy. Although initial outcomes are encouraging, long-term durability remains unknown. 相似文献