P005. A Case Report of One-Stage Surgery for a Giant Arch-Descending Aortic Aneurysm by TEVAR Under Circulatory Arrest
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Department of cardiovascular surgery, Na
Japan - Contact Me
T.Hishikawa is a cardiac surgeon at Nagoya Tokushukai General Hospital. He graduated from the Department of Medicine of Nagoya City University in 2018 and worked as a resident at Tokyonishi Tokushukai Hospital till March 2020. Presently, he is affiliated with Nagoya Tokushukai General hospital, a position he has held since April 2020. His areas of strong interest are aortic surgery. On the other hand, he has authored a wide variety of papers on the heart and aorta. He has published a study of surgical outcomes under COVID-19 disaster, a study using cardiac MRI,etc.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective: In the treatment of thoracic aortic aneurysms, one-stage total thoracic aortic replacement presents risks in older and frail patients, and two-staged descending aortic replacement using the elephant trunk is also considered very invasive. Currently, thoracic endovascular aortic repair (TEVAR) is performed as a two-staged procedure of the elephant trunk technique. However, two-staged TEVAR is difficult to perform in cases of intravascular atheroma, intramural thrombus, rupture, or imminent rupture conditions.
Methods: The invasiveness of surgery can be minimized by performing an ascending arch replacement through a median sternotomy, inserting the elephant trunk during circulatory arrest, and performing TEVAR while maintaining circulatory arrest. Blood can be pumped through the sheath from the femoral artery to blow off the debris in the aorta upon resumption of circulation, reducing the risk of peripheral emboli.
Results: In this study, we report the case of a 67-year-old man with a giant aneurysm from the arch to the descending aorta who underwent a one-stage frozen elephant trunk and TEVAR procedure which covered the aortic aneurysm without paraplegia. The patient presented with a 2-year history of cough, exertional shortness of breath, significant weight loss, and an imminent rupture risk. The patient's recovery was uneventful, and he was transferred on postoperative day 64 for rehabilitation in preparation for discharge.
Conclusions: This method allows for minimally invasive surgery as it allows for the replacement of the ascending and descending aorta in a single-stage procedure through median sternotomy. However, the risk of paraplegia should be considered because the descending aorta is covered in one stage.
Authors
Takanori Hishikawa (1), Takeki Ohashi (1), Soichiro Kageyama (1), Akinori Kojima (1)
Institutions
(1) Nagoya Tokushu-kai general hospital, Kasugai city Aichi, Japan
Methods: The invasiveness of surgery can be minimized by performing an ascending arch replacement through a median sternotomy, inserting the elephant trunk during circulatory arrest, and performing TEVAR while maintaining circulatory arrest. Blood can be pumped through the sheath from the femoral artery to blow off the debris in the aorta upon resumption of circulation, reducing the risk of peripheral emboli.
Results: In this study, we report the case of a 67-year-old man with a giant aneurysm from the arch to the descending aorta who underwent a one-stage frozen elephant trunk and TEVAR procedure which covered the aortic aneurysm without paraplegia. The patient presented with a 2-year history of cough, exertional shortness of breath, significant weight loss, and an imminent rupture risk. The patient's recovery was uneventful, and he was transferred on postoperative day 64 for rehabilitation in preparation for discharge.
Conclusions: This method allows for minimally invasive surgery as it allows for the replacement of the ascending and descending aorta in a single-stage procedure through median sternotomy. However, the risk of paraplegia should be considered because the descending aorta is covered in one stage.
Authors
Takanori Hishikawa (1), Takeki Ohashi (1), Soichiro Kageyama (1), Akinori Kojima (1)
Institutions
(1) Nagoya Tokushu-kai general hospital, Kasugai city Aichi, Japan
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.