A Successful Case of Selective Intercostal Arterial Perfusion in a Patient with Ruptured Thoraco-Abdominal Aortic Aneurysm

iDepartment of Thoracic and Cardiovascular Surgery, Sapporo Medical University, Sapporo, Japanj

Tomohiro Nakajima Toshiro Ito Nobuyoshi Kawaharada
Mayuko Uehara Yohsuke Yanase Masaki Tabuchi
Akihiko Yamauchi Tetsuya Higami
A 61-year-old man underwent thoracic aortic graft replacement and abdominal aortic graft replacement because of a dissecting aneurysm. He presented with a ruptured residual dissecting thoraco-abdominal aortic aneurysm and underwent emergency thoraco-abdominal aortic graft replacement in February 2007. An inverted bifurcated graft was fashioned by cutting one of the two graft legs and creating an elliptical patch, like a cobra-head. In order to prevent paraplegia after the operation, it was necessary to shorten the duration of spinal cord ischemia. Once the elliptical patch was sutured to the orifices of the internal costal arteries with running sutures, selective intercostal arterial perfusion was initiated by using a cardiopulmonary bypass. After the operation, he did not suffer paraplegia.
  Jpn. J. Cardiovasc. Surg. 38:273-275i2009j