|Pitfalls in Open Stent Grafting
for Distal Aortic Arch Aneurysm
（Cardiovascular Surgery, National Hospital Kure
Medical Center, Hiroshima, Japan)
|A 72-year-old woman underwent surgical
stent graft implantation for a huge distal arch aneurysm（12×11cm).
Axillo-bifemoral bypass was added in order to restore visceral
perfusion. Severe metabolic acidosis developed after the operation,
and the patient died 6 hours after surgery. Autopsy showed thromboembolism
of the superior mesenteric artery and aortic dissection in the
descending thoracic aorta because of stent graft insertion into
a false lumen. To reduce complications like this case, we should
consider the peculiar anatomic features and thoroughly evaluate
atheromatous changes in the aortic wall with improvement of the
shape of the sheath and delivery system.
Jpn. J. Cardiovasc. Surg. 31：139-142(2002)