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J Thorac Cardiovasc Surg 2007;134:1589-1591
© 2007 The American Association for Thoracic Surgery

Brief Communication

Right minithoracotomy as an alternative approach for endovascular repair of thoracic aortic aneurysm

^a Division of Cardiothoracic Surgery, Department of Cardiopulmonary Sciences, University of Udine Medical School, Udine, Italy
^b Division of Vascular and Interventional Radiology, Department of Radiologic Sciences, University of Udine Medical School, Udine, Italy.

Received for publication June 8, 2007; accepted for publication June 22, 2007.

^_* Address for reprints: Igor Vendramin, MD, Division of Cardiothoracic Surgery, Department of Cardiopulmonary Sciences, Piazzale Santa Maria della Misericordia, Udine 33100, Italy. (Email: Igor.vendramin@virgilio.it).

The first 20% of the full text of this article appears below.

Endovascular repair of chronic descending thoracic aortic diseases (aneurysm and dissection) is now a widely used treatment with satisfactory short- and midterm results in terms of morbidity and mortality.^1,2 Nevertheless, absence of available traditional access (femoral artery, iliac artery, right subclavian artery) remains a great challenge for physicians who have to explore new strategies to avoid major surgical approaches.

We report the case of a thoracoabdominal aortic aneurysm treated with stent grafts implanted through the ascending aorta with a right anterior minithoracotomy approach.

Clinical Summary

A 59-year-old man had a thoracoabdominal aneurysm and severe atherosclerotic disease of the femoral and iliac arteries and brachiocephalic trunk, causing severe and obstructive stenoses. The abdominal aorta was not available because of the aneurysmatic disease nor was the right subclavian artery owing to kinking. Preoperative imaging (computed tomographic [CT] scan) demonstrated an aneurysm involving the descending aorta between the left subclavian artery (LSA) and the celiac trunk (Figure 1, A) and a second subrenal abdominal aortic aneurysm.

View larger version (87K):   Figure 1. A CT angiogram depicts aortic aneurysm involving the descending aorta (A) and the result of stent grafting of the descending aorta (D). A 10-mm Dacron T-tube was sutured in the ascending aorta (B). . . . [Full Text of this Article]

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				G. Bruschi, F. De Marco, P. Fratto, J. Oreglia, P. Colombo, R. Paino, S. Klugmann, and L. Martinelli Direct aortic access through right minithoracotomy for implantation of self-expanding aortic bioprosthetic valves J. Thorac. Cardiovasc. Surg., September 1, 2010; 140(3): 715 - 717. [Full Text] [PDF]