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Extensive replacement of the aorta from the ascending aorta to the supraceliac abdominal aorta during a one-stage operation
Authors:Toshifumi Murashita  Keishu Yasuda  Yoshiro Matsui  Norihiko Shiiya  Shigeyuki Sasaki  Makoto Sakuma
Affiliation:(1) Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Kita-14, Nishi-5, Kita-ku, 060 Sapporo, Japan
Abstract:A successful replacement of the aorta from the ascending aorta to the supraceliac abdominal aorta in one operation is herein reported. The patient was 66-year-old woman who had DeBakey type I chronic aortic dissection with a pre-disseminated intravascular coagulation (DIC) condition. The image diagnosis revealed a markedly enlarged false lumen with a narrow true lumen in the ascending aorta extending to the diaphragm level while below the diaphragm level, the aortic dilatation was mild. The operation was performed through both a thoracoabdominal incision and a median sternotomy to expose the whole thoracic aorta, and the aorta was replaced from the ascending aorta to the supraceliac abdominal aorta. Selective cerebral perfusion was used for cerebral protection and this was a useful adjunct since no time limitations were thus required during repair of the aortic arch. Although the patient developed several complications postoperatively, she eventually recovered and was discharged from the hospital without any neurological disorders.
Keywords:DeBakey type I dissecting aortic aneurysm  selective cerebral perfusion  impending rupture  extensive aortic replacement
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