European Journal of Cardio-Thoracic Surgery, Vol 10, 477-479, Copyright © 1996 by European Association for Cardio-thoracic Surgery
Type B dissection involving a right-sided aortic arch
V Senthil and T Treasure
Cardiothoracic Surgery Unit, St. George's Hospital, London, UK.
Type B dissection involving a right-sided aortic arch is a very rare
condition. Here we describe such an occurrence in an elderly patient who
was initially managed medically but later underwent successful surgical
repair after developing symptoms of expanding dissection. The dissection
was approached through a right thoracotomy. Because of the unusual origin
of the arch vessels and the direction of the dissected segment, aortic
clamps could not be positioned satisfactorily, necessitating the use of
full cardiopulmonary bypass and deep hypothermic circulatory arrest for the
repair. The indications for surgery in Type B dissection and the
modifications in the surgical strategy necessitated by the abnormal anatomy
are discussed.
