A Case of a Super-Elderly Patient Who Underwent Total Arch Replacement Using the Frozen Elephant Trunk Technique for a Thoracic Aortic Aneurysm with a Right-Sided Aortic Arch

Takashi Kato＊	Hirotsugu Fukuda＊	Wataru Moriyama＊
Masataka Ohashi＊	Shotaro Hirota＊	Masahiro Seki＊
Masahiro Teduka＊	Yusuke Takei＊	Hironaga Ogawa＊
Ikuko Shibasaki＊

（Department of Cardiac and Vascular Surgery, Dokkyo Medical University Hospital＊, Tochigi, Japan）

The case is that of a 90-years-old man. A previous doctor performed abdominal graft replacement for an abdominal aortic aneurysm 5 years earlier and continued outpatient CT follow-up. Follow-up CT showed the right aortic arch and dilation of the thoracic aortic aneurysm, and the patient was referred to our hospital. Contrast-enhanced CT showed an aortic arch aneurysm;the aneurysm diameter was 62mm in major axis and 60mm in minor axis, which was judged to be suitable for surgery. It was a rare right-sided aortic arch with no congenital heart malformation and no situs inversus. Endovascular treatment was considered because he was 90 years old and very elderly, but there were concerns about the risk of embolism, irregular manipulation and central landing. For the surgical method, we selected total arch replacement using a frozen elephant trunk technique. We succeeded in avoiding serious complications by selecting an appropriate treatment method through careful evaluation.

 

Jpn. J. Cardiovasc. Surg. 50:317-321（2021）

Keywords：right aortic arch;total arch replacement;frozen elephant trunk