title: Multiple aneurysm repair: hybrid approach to chronic dissection around visceral branches.
abstract: The present case report details our experience with the hybrid approach for multiple aneurysms in the aortic arch, thoracoabdominal aorta, and around the aortic bifurcation. Total arch replacement for the arch aneurysm under hypothermic cardiopulmonary bypass with antegrade cerebral perfusion was the first stage of aneurysm repair. Five months later, bifurcated graft replacement with debranching of four abdominal branches was undertaken as the second stage of treatment. Finally, stent-graft repair for chronic dissection of the thoracoabdominal aorta was performed utilizing a Gore-Tex Tag endovascular prosthesis. Over 7 months of treatment, all aneurysms were excluded from the aortic blood flow and pressure without abdominal organ dysfunction except a transiently elevated total bilirubin level. Although the patient had an episode of minor gastrointestinal bleeding after discharge, he is currently leading a normal life without limitations at home 5 months after the stent-graft repair.
authors.affiliation: Department of Cardiovascular Surgery, Nagara Medical Center, 1300-7 Nagara, Gifu 502-8558, Japan. handa-kcgh@umin.ac.jp
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Handa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishina
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kato
authors.forename: Itsuki
authors.initials: I
authors.lastname: Nishio
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asano
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Noda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Yoichirou
authors.initials: Y
authors.lastname: Ueno
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome