Eur J Cardiothorac Surg 2006;29:1046
© 2006 Elsevier Science NL
Images in cardio-thoracic surgery |
Malformation of the thoracic aorta associated to aneurysms of the arch: an extraanatomic surgical approach
Franco Grego
*
,
Michele Antonello,
Rudi Stramanà,
Giovanni P. Deriu
Division of Vascular Surgery, University of Padua, 35125 Padova, Italy
Received 31 October 2005;
received in revised form 7 February 2006;
accepted 13 February 2006.
* Corresponding author. Tel.: +39 049 8211396; fax: +39 049 8212637. (Email: franco.grego{at}unipd.it).
Key Words: Right-sided aortic arch • Malformation of the thoracic aorta
We described an uncommon malformation of the thoracic aorta in a 29-year-old Iranian woman (Fig. 1
). Through median sternotomy and 5th intercostal space toracotomy without circulatory arrest, we performed an end-to-side ascending–descending aorta bypass using a 20-mm Wowen graft, positioned above the pericardic sac and through the mediastinic pleura. Surgical procedure ended with aneurysmectomy (Fig. 2
).
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Fig. 1. Angio-MR (a) and DSA of the thoracic aorta (b) show two aneurysms in a right-sided aortic arch. The right common carotid artery takes origin from the ascending aorta; the right subclavian artery and the left brachiocephalic trunk take origin from the descending aorta. A second DSA via interatrial transeptal injection of contrast shows a coarctation with a 100 mmHg gradient of pressure (c) (the arrow indicates the coarctation).
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