A Case of Open Stent Grafting for Thoracic Aortic Aneurysm Combined with Atypical Coarctation and Aortic Regurgitation

(Department of Cardiovascular Surgery, Sakakibara Hospital, Okayama, Japan)

Hidenori Yoshitaka Takato Hata Yoshimasa Tsushima
Satoru Otani
A 58-year-old woman admitted for further examination of the proximal descending thoracic aortic aneurysm (TAA) combined with atypical coarctation and aortic regurgitation (AR). The chest CT and aortography confirmed these diagnoses, and revealed a pressure gradient of 40mmHg at the descending thoracic aorta with a severe calcification of the aortic wall, and severe AR. We scheduled a one-stage operation for this patient. First, we performed aortic valve replacement. Then we made a graft replacement from the aortic arch to the descending aorta using a stent graft via the aortic arch. Finally we did a reconstruction for lower limb perfusion using an aorto-iliac (extra-anatomical) bypass. The patient is now doing well 3 years after the surgery without any endoleak and without any difference of blood pressure between upper and lower limbs.
@Jpn. J. Cardiovasc. Surg. 34: 51-54 (2005)