title: Hybrid aortic arch repair for a ruptured and infected penetrating atherosclerotic ulcer of the aortic arch.
abstract: Aortic arch rupture is a life-threatening emergency. Conventional open surgical repair carries a high mortality and morbidity. We report a case of an elderly patient who suffered from a ruptured and infected penetrating ulcer of the aortic arch. A hybrid operation was performed, consisting of a right-to-left carotid bypass and transposition of the left subclavian artery into the left common carotid artery followed by endovascular repair of the aortic arch. Antibiotic therapy, based on the results of culture and sensitivity tests for Staphylococcus aureus, was administered for 6 months. The patient recovered uneventfully and remains asymptomatic 16 months after the procedure. However, long-term follow-up is mandatory to determine the efficacy and the durability of this technique.
authors.affiliation: Department of Vascular and Thoracic Surgery, Arnaud de Villeneuve Hospital, Montpellier, France. ludoviccanaud@hotmail.com
authors.forename: Ludovic
authors.initials: L
authors.lastname: Canaud
authors.forename: Kheira
authors.initials: K
authors.lastname: Hireche
authors.forename: Thomas
authors.initials: T
authors.lastname: D'annoville
authors.forename: Pierre
authors.initials: P
authors.lastname: Alric
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002339:Carotid Arteries / Q000601:surgery; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D015607:Stents; D013348:Subclavian Artery / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D014656:Vascular Surgical Procedures
chemical_list: D000900:Anti-Bacterial Agents