Extended total arch replacement for type B aortic dissection with ascending aneurysm following healed aortic dissection.
We describe a case of type B aortic dissection with large ascending aortic aneurysm occurring 12.8 years after aortic root replacement (Cabrol procedure) in a non-Marfan patient with cystic medial necrosis of the aorta. We have successfully performed an extended total aortic arch replacement using a four-branched graft through the "L-incision" approach (a combination of a left anterior thoracotomy and upper half median sternotomy). Of note, a histological specimen from the aneurysmal ascending aortic wall revealed "healed aortic dissection" with fibrous tissue replacing the media and intima in addition to multiple foci of cystic medial necrosis.
Ochiai
Yoshie
Y
Department of Cardiovascular Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
Kurisu
Kazuhiro
K
Kajiwara
Takashi
T
Kumeda
Hiroshi
H
Tominaga
Ryuji
R
D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001011:Aorta / Q000473:pathology*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006801:Humans; D008297:Male; D009336:Necrosis; D014057:Tomography, X-Ray Computed