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RESEARCH PRODUCT
A New Off-Pump Hybrid Open and Endovascular Repair to Treat Ductus Botalli and Ascendens Aneurysms
Felice PecoraroZoran RancicThomas PfammatterFrank J. VeithFrank J. VeithFrank J. VeithDieter MayerMario Lachatsubject
MaleAortic archmedicine.medical_specialtyAortographymedicine.medical_treatment610 Medicine & healthAorta ThoracicAortographySettore MED/22 - Chirurgia Vascolare2705 Cardiology and Cardiovascular MedicineBlood Vessel Prosthesis ImplantationAortic aneurysmAneurysmmedicine.arteryAscending aortamedicineHumansThoracic aortacardiovascular diseasesDuctus Arteriosus PatentAgedCardiopulmonary Bypassmedicine.diagnostic_test10042 Clinic for Diagnostic and Interventional Radiologybusiness.industryEndovascular Proceduresaortic arch aortic operation carotid afteries endovascular procedures vascular diseaseStentGeneral Medicinemedicine.disease10020 Clinic for Cardiac Surgery2746 SurgeryAortic AneurysmSurgeryTreatment Outcomesurgical procedures operativeDescending aortacardiovascular systemSurgeryRadiologyTomography X-Ray ComputedCardiology and Cardiovascular Medicinebusinessdescription
To report a combined ascending aorta and aortic arch hybrid repair, we performed off-pump with no aortic graft replacement. A 65-year-old man, developing progressive recurrent laryngeal nerve paralysis, underwent a computed tomography (CT) angiography detecting nonpatent residual ductus Botalli aneurysm and ascending aorta aneurysm. Due to severe multimorbidities, a less-invasive alternative was elaborated. In a first step, appropriate proximal landing zone for aortic stent grafting was achieved by ascending aorta diameter reduction, with epiaortic wrapping, and debranching the supra-aortic trunks. In the second step, endovascular stent grafts were deployed from proximal ascending aorta to descending aorta, excluding the ductus Botalli aneurysm. Six-month follow-up CT shows ductus Botalli aneurysm exclusion, stable stent graft position, and ascending diameter and patent and stenosis-free supra-aortic grafts. This case supports this alternative treatment to open aortic repair under circulatory arrest and deep hypothermia, especially in those patients considered unfit for such invasive treatment.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2012-01-01 | Vascular and Endovascular Surgery |