| Transaortic Endovascular Stent
Grafting: An Acceptable Alternative for Aortic Arch Surgery |
(Department of Cardiovascular Surgery, Sakakibara
Hospital, Okayama, Japan)
| Hidenori Yoshitaka |
Takato Hata |
Yoshimasa Tsushima |
| Mitsuaki Matsumoto |
Souhei Hamanaka |
Kotaro Suehiro |
| Satoru Otani |
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Endovascular grafting via the aortic
arch, a novel alternative method for aortic aneurysm repair,
was performed in 18 patients with aortic arch or distal arch
aneurysms. For cerebral protection, selective or retrograde cerebral
perfusion was used during delivery and deployment of the stented
graft through the aortotomy. Selective cerebral perfusion was
performed through both cerebral arteries and the left subclavian
artery. Throughout this procedure, the aorta was filled with
carbon dioxide to prevent the spinal arteries from air embolism.
Two patients were lost, one due to myocardial infarction and
one due to pneumonia. Endoluminal leakage was found in 2 patients,
for which reoperation was required. However, no cerebral or spinal
complications were observed in this series. Thus we conclude
that endovascular stent grafting via the aortic arch is an acceptable
alternative for the aortic arch or distal arch aneurysm repair
with little risk of cerebral or spinal complications.
Jpn. J. Cardiovasc. Surg. 32：9-12(2003) |
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