J Thorac Cardiovasc Surg 2006;131:235-236
© 2006 The American Association for Thoracic Surgery
a Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
b Department of Radiology, Hannover Medical School, Hannover, Germany
Received for publication July 8, 2005; revisions received August 14, 2005; accepted for publication August 19, 2005. * Address for reprints: Christian Kühn, MD, Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany (Email: email@example.com).
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A 60-year-old man with distal aortic ascending aneurysm, aortic arch aneurysm and subacute rupture of the descending aorta had undergone aortic valve repair and proximal ascending aorta replacement following acute type A aortic dissection 26 years ago. Surgical therapy included replacement of distal ascending, arch, and complete thoracoabdominal descending aorta using selective antegrade cerebral and abdominal organ perfusion, reinsertion of the brachiocephalic trunc, left carotid artery, two intercostal arteries (Th-9/10), reimplantation of both renal arteries, the superior mesenteric artery and coeliac trunc through a left-sided thoracotomy and thoracoabdominal approach.
A patient underwent emergency aortic valve reconstruction combined with proximal ascending aorta replacement following traumatic type A aortic dissection after a ski-accident 26 years ago. The following years were uneventful and the patient was in good condition without signs of kidney dysfunction or abdominal malperfusion. An increasing aneurysm (diameter 4,5 cm) of the left common iliac artery was resected and a 10 mm Dacron tube graft inserted two years ago. A computed tomography scan one year later showed the known dissection of the aortic arch and descending aorta (Figure 1). However, diameter of
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