Temporary extra-anatomic brain perfusion followed by total rerouting of the supra-aortic vessels for hybrid repair of a ruptured aortic arch aneurysm

Hybrid repair of ruptured aortic arch repair has been proposed as a valuable approach. However, the presence of an anterior mediastinal hematoma must be carefully detected because of the inherent risk of rupture at sternotomy. We report the case of a patient presenting a ruptured aortic arch aneurys...

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Bibliographic Details
Published in:Journal of vascular surgery 2011-10, Vol.54 (4), p.1145-1147
Main Authors: Joyeux, Frederic, MD, Canaud, Ludovic, MD, Hireche, Kheira, MD, Berthet, Jean-Philippe, MD, Marty-Ane, Charles, MD, PhD, Alric, Pierre, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Aortic Aneurysm, Thoracic - complications
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - physiopathology
Aortic Aneurysm, Thoracic - surgery
Aortic Rupture - diagnostic imaging
Aortic Rupture - etiology
Aortic Rupture - physiopathology
Aortic Rupture - surgery
Aortography - methods
Biological and medical sciences
Blood and lymphatic vessels
Blood Vessel Prosthesis Implantation
Cardiology. Vascular system
Cerebrovascular Circulation
Diseases of the aorta
Endovascular Procedures
Hematoma - diagnostic imaging
Hematoma - etiology
Hemodynamics
Humans
Male
Medical sciences
Perfusion - methods
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tomography, X-Ray Computed
Treatment Outcome
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Summary:Hybrid repair of ruptured aortic arch repair has been proposed as a valuable approach. However, the presence of an anterior mediastinal hematoma must be carefully detected because of the inherent risk of rupture at sternotomy. We report the case of a patient presenting a ruptured aortic arch aneurysm with anterior rupture who underwent hybrid repair using a temporary extra-anatomic brain perfusion followed by total rerouting of the supra-aortic trunks. We propose this adjunctive technique as a means of allowing a safe endovascular exclusion of aortic arch lesions and avoiding the risk of acute and total aortic rupture in case of anterior rupture of aortic arch aneurysms.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2011.03.271