Cor Vasa 2008, 50(4):167-169 | DOI: 10.33678/cor.2008.056

Hybrid, off-the-pump management of atherosclerotic ulcers of the aortic arch.

Martin Urban¹, Lubomír Blaha², Marian Wierzgoň³, Piotr Branny¹, Daniel Říha², Stanislav Holesz³

¹ Kardiochirurgické oddělení

² Centrum cévní a miniinvazivní chirurgie

³ Oddělení intervenční radiologie, Nemocnice Podlesí, a. s., Třinec, Česká republika

In addition to aneurysms, atherosclerotic ulcers of the aortic arch are a clear sign of extensive atherosclerotic lesions involving the aorta and brachiocephalic branches of the arch. The ulcers are the clinical equivalent of aneurysms and pose, among other things, the risk of rupture with bleeding fatal for the patient. Conventional surgical management requires the use of the extracorporeal circuit. The procedure is performed in deep hypothermia with circulatory arrest and selective brain perfusion or, alternatively, in mild hypothermia with selective perfusion of the brain and the lower part of the body. These procedures are associated with higher surgical mortality and morbidity rates and, in particular, a high risk of serious neurological complications. In their case report, the authors describe the case of a patient with two aortic arch ulcers in the presence of severe atherosclerotic lesions involving the ascending aorta and aortic arch. A hybrid approach consisting of surgical bypass of a branch of the aortic arch combined with coronary artery bypass grafting, with subsequent removal of ulcers and stent graft implantation in the aortic arch is described.

Keywords: Atherosclerotic ulcer of the aortic arch; Stent graft; Aortocarotid bypass

Published: April 1, 2008  Show citation