Staged Approach Using Proximal Open-Stenting Technique and Distal Open Repair for the Treatment of Extensive Thoracic Aortic Aneurysms

Toru Mizumoto	Satoshi Teranishi	Hisato Ito
Yasuhiro Sawada	Naoki Yamamoto	Shinji Kanemitsu

（Department of CardioThoracic Surgery, Anjo Kosei Hospital＊, Anjo, Japan, and Department of CardioThoracic Surgery, Mie University Hospital＊＊, Mie, Japan）

A 50-year-old man with an extensive thoracic aortic aneurysm underwent staged surgery which consisted of preceding total aortic arch replacement with the frozen elephant trunk technique using J Graft Open Stent Graft●R, followed by open thoracoabdominal aortic aneurysm repair. During the second operation, the descending aorta was cross clamped along with the preexisting stent graft, and Dacron graft was anastomosed directly to the stent graft using a running 4-0 monofilament suture. The anastomosis site was then covered with a short piece of Dacron graft identical with the stent graft in size to secure hemostasis. We herein discuss our approach in this complex case, focusing on prevention of inadvertent events such as deformation of the preexisting stent graft and unexpected bleeding.

 

Jpn. J. Cardiovasc. Surg. 46:139-142（2017）

Keywords：J Graft Open Stent Graft●R;open surgery;direct graft anastomosis