title: A staged total aortic replacement with combined endovascular and open surgery: report of a case.
abstract: For a 75 year-old man with extensive aortic aneurysm, who had undergone a previous infra-renal abdominal Y-graft, a staged replacement of remaining segments was performed. A hybrid procedure of open-laparotomy debranching of visceral branches and endovascular stentgraft insertion in the thoracoabdominal aorta was performed first, followed by subsequent direct replacement between the proximal ascending and distal arch using cardiopulmonary bypass. Three months thereafter dissection of enlarged proximal descending aorta occurred, for which we performed an emergent endovascular stentgraft deployment which bridged "elephant trunk" of the arch graft and the previous stentgraft. Consequently total aortic replacement was successfully accomplished without any neurological sequela.
authors.affiliation: Department of Cardiovascular Surgery, Heart Center, St Luke's International Hospital, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Sunao
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kohei
authors.initials: K
authors.lastname: Abe
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Kazui
authors.forename: Kohei
authors.initials: K
authors.lastname: Kawazoe
keywords: dissection; endovascular surgery; hybrid therapy
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