title: Hybrid treatment of a ruptured aneurysm in the distal aortic arch: report of a case.
abstract: An 80-year-old man was transferred to our hospital for surgical treatment of a ruptured aortic arch aneurysm. Based on a history of severe heart failure and coronary artery bypass, we considered him unsuitable for conventional open repair. He underwent a hybrid repair, in the form of supra-aortic vessel debranching followed by endoluminal aortic repair. Although the ostia of the left carotid and left subclavian arteries were occluded by the stent-graft, the left supra-aortic vessels and the left internal thoracic artery attached to the coronary artery were perfused through an extra-anatomic bypass from the right axillary artery to the left carotid artery and the left axillary artery. After additional endovascular repair for recurrent hemosputum, the patient recovered without complications. Although continued follow-up is necessary, acute hybrid arch repair seems feasible for treating ruptured aortic arch aneurysms, even in the setting of severe heart failure and a previous coronary artery bypass.
authors.affiliation: Department of Cardiovascular Surgery, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. shimizu.md@gmail.com
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamabe
authors.forename: Soshu
authors.initials: S
authors.lastname: Kotani
authors.forename: Ryohei
authors.initials: R
authors.lastname: Yozu
mesh_terms: D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D008297:Male