A Case of Distal Aortic Arch Aneurysm 45 Years after Left Thoracoplasty

(Department of Cardiovascular Surgery, Saitama Cardiovascular and Respiratory Center, Saitama, Japan)

Katsuhisa Onoguchi Takashi Hachiya Tatsuumi Sasaki
Kazuhiro Hashimoto Hiromitsu Takakura Motohiro Oshiumi
Shigeyuki Takeuchi
A 76-year-old man developed dysphagia and esophageal stenosis was diagnosed. A computed tomographic scan of the chest demonstrated a large aneurysm of the distal aortic arch. The patient had undergone left thoracoplasty 45 years previously for the treatment of lung tuberculosis, then the aortic arch with the aneurysm was displaced backward because of the narrowed upper thoracic cavity and the esophagus was sandwiched between the aortic arch and the spine. The patient was thought to be in danger of developing an aortoesophageal fistula, so an emergency operation was performed in spite of his age and general condition. He was successfully treated with graft replacement including reconstruction of three arch vessels and his severe dysphagia improved.
@Jpn. J. Cardiovasc. Surg. 29F282-285 (2000)