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Eur J Cardiothorac Surg 1999;16:356-358
© 1999 Elsevier Science NL

How to do it

Implantation of an endovascular covered stent-graft for distal aortic arch aneurysm via midsternotomy under pigtail catheter guidance

^a Department of Thoracic Surgery, Nagoya University School of Medicine, Nagoya, Japan
^b Department of Cardiac Surgery, Nagoya second Red-Cross Hospital, Nagoya, Japan
^c Department of First Surgery, Nagoya University School of Medicine, Nagoya, Japan
^d Department of Radiology, Nagoya University School of Medicine, Nagoya, Japan

Corresponding author. 65 Tsurumai, Showa-ku, Nagoya 466-0065, Japan. Tel.: +81-52-744-2376; fax: +81-52-744-2383

We implanted an endovascular covered stent-graft for distal aortic arch aneurysm involving the left subclavian artery in 12 cases. A stent-graft was delivered just below the aneurysm via aortotomy with direct vision using a 12 F delivery sheath under guidance of a pigtail catheter placed via the groin artery. The proximal anastomosis of the stent-graft was performed with inclusion technique, and the aortotomy was then closed with it. This technique reduces operative damage by eliminating distal anastomosis and should reduce operative mortality and morbidity.

Key Words: Stent graft • Aortic arch aneurysm • Pigtail catheter

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