Open supra-aortic revascularization and arch reconstruction after previous TEVAR in a complex arch anatomy.
Multimed Man Cardiothorac Surg
; 20212021 06 16.
Article
in En
| MEDLINE
| ID: mdl-34143578
ABSTRACT
We propose a technique to minimize the neurological and systemic risks involved in rerouting the blood flow toward the brain in a "single remaining vessel" configuration with a 90% stenosis by means of complete hypothermic cerebral protection associated with normothermic systemic blood flow with a "restitutio ad integrum" of the supra-aortic trunks flow. The perfusion of the brain and the arms was almost completely separated from the systemic perfusion by the deployment 1 year before of a thoracic endoprosthesis in association with complete chronic occlusion of the brachiocephalic trunk and a functioning carotid-subclavian bypass. The Free Flow of the prosthesis, which acted as a hook, moved the calcium toward the left carotid ostium, creating a 90% stenosis with intermittent acute cerebral hypoperfusion and amaurosis. We achieved an optimal result:
The patient was discharged on postoperative day 7 with no neurological problems and with patency and direct blood flow in all the supra-aortic trunks.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aorta, Thoracic
/
Endovascular Procedures
Type of study:
Etiology_studies
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
Multimed Man Cardiothorac Surg
Year:
2021
Document type:
Article