Open aortic surgical repair for left hemi-arch stent-graft failure

Vincenzo Rampoldi, Santi Trimarchi, Paolo Righini, Valerio Tolva, Luigi Inglese

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

A surgical technique of endovascular graft explant through an open aortic approach for left hemi-arch stent-graft failure is described. Between January and April 2003, we surgically treated 3 patients previously submitted for stent grafts for isthmic aortic diseases. Two patients had atherosclerotic aneurysm and 1 had a false lumen reperfusion of subacute intramural hematoma. At 6 to 8 months computed tomographic scan follow-ups on all patients showed a rapid enlargement of aortic diameters due to type I endoleaks. The presence of an uncovered proximal stent in the parasubclavian aorta did not allow a simple aortic cross clamping; therefore we performed an open aortic procedure through a left posterolateral thoracotomy, using femoro-femoral bypass and mild hypothermic circulatory arrest. Selective antegrade cerebral perfusion was started within 3 to 5 minutes from aortotomy and graft removal. Left hemi-arch and descending thoracic aortic replacement was then performed with continuous cerebral perfusion. No surgical mortality was observed. Postoperative course was uneventful for neurologic, cardiac, respiratory, and renal complications. The 3-month follow-ups were event free. This approach, associated with rapid stent-graft explant and selective cerebral antegrade perfusion, appears to be a safe and effective surgical strategy for treating this new aortic pathology.

Original languageEnglish
Pages (from-to)1075-1078
Number of pages4
JournalAnnals of Thoracic Surgery
Volume78
Issue number3
DOIs
Publication statusPublished - Sep 2004

Fingerprint

Stents
Transplants
Perfusion
Endoleak
Aortic Diseases
Endovascular Procedures
Thoracotomy
Thigh
Constriction
Hematoma
Nervous System
Reperfusion
Aneurysm
Aorta
Thorax
Pathology
Kidney
Mortality

Keywords

  • 26

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Rampoldi, V., Trimarchi, S., Righini, P., Tolva, V., & Inglese, L. (2004). Open aortic surgical repair for left hemi-arch stent-graft failure. Annals of Thoracic Surgery, 78(3), 1075-1078. https://doi.org/10.1016/j.athoracsur.2004.03.047

Open aortic surgical repair for left hemi-arch stent-graft failure. / Rampoldi, Vincenzo; Trimarchi, Santi; Righini, Paolo; Tolva, Valerio; Inglese, Luigi.

In: Annals of Thoracic Surgery, Vol. 78, No. 3, 09.2004, p. 1075-1078.

Research output: Contribution to journalArticle

Rampoldi, V, Trimarchi, S, Righini, P, Tolva, V & Inglese, L 2004, 'Open aortic surgical repair for left hemi-arch stent-graft failure', Annals of Thoracic Surgery, vol. 78, no. 3, pp. 1075-1078. https://doi.org/10.1016/j.athoracsur.2004.03.047
Rampoldi, Vincenzo ; Trimarchi, Santi ; Righini, Paolo ; Tolva, Valerio ; Inglese, Luigi. / Open aortic surgical repair for left hemi-arch stent-graft failure. In: Annals of Thoracic Surgery. 2004 ; Vol. 78, No. 3. pp. 1075-1078.
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