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Eur J Cardiothorac Surg 2005;27:649-653
© 2005 Elsevier Science NL

Stent grafting technique using Matsui-Kitamura (MK) stent for patients with aortic arch aneurysm

Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai City, Miyagi Prefecture, 980-8574, Japan

Received 19 September 2004; received in revised form 16 December 2004; accepted 21 December 2004.

^* Corresponding author. Tel.: +81 22 717 7222; fax: +81 22 717 7227. (E-mail: june-a{at}mail.tains.tohoku.ac.jp).

Objective: Although several methods of stent-grafting for patients with aortic arch aneurysm have been reported, these methods have been associated with several complications such as endoleak and migration. We developed a new method using Matsui-Kitamura (MK) stent-graft following extra-anatomic arch vessels bypass by selective cerebral perfusion (SCP) under left heart bypass (LHB). Methods: Between December 2001 and December 2003, 12 patients with aortic arch aneurysm were treated according to this new method. All patients were male with an average age of 71.3 ± 6.4 years. There were 5 patients with severe pulmonary dysfunction, 4 with renal dysfunction, one with severe cardiac dysfunction and 3 with preoperative cerebral infarction. Under SCP using LHB, the extra-anatomic arch vessel bypass was established. The MK stent-graft was delivered into the aortic arch. Coronary artery bypass grafting (CABG) was concomitantly performed in one patient. Results: There were no cases of endoleak, migration or hospital death. One patient, who had a past history of cerebrovascular disease, suffered a minor stroke, and one patient, who was performed CABG to the mid-left anterior descending branch (LAD) using the left internal thoracic artery (LITA), presented paraparesis. Although two patients of chronic renal failure underwent scheduled CHDF on account of using the contrast medium during the procedure, all of them were weaned from hemodialysis. However, there were no other postoperative complications such as, respiratory failure or cardiac dysfunction. Conclusions: Endovascular stent grafting EVSG using the MK stent with extra-anatomic arch vessel bypass under SCP using LHB could be a useful and less invasive method for patients with aortic arch aneurysm who are at a high surgical risk.

Key Words: Aortic arch aneurysm • Stent-graft • Extra-anatomical bypass • Selective cerebral perfusion • Left heart bypass

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