title: Modified arch-first technique performed on a beating heart for an arch aneurysm with atheromatous plaques.
abstract: A shaggy aorta with unstable atheromatous plaques has a high risk of neurologic complications in cases of arch aneurysm. We report the use of a modified arch-first technique involving arch replacement for a beating heart after reconstruction of supra-aortic vessels while maintaining normal blood pressure. The procedure was performed in a patient who had an arch aneurysm, complicated by an aberrant right subclavian artery (ARSA) and a shaggy aorta ascending to the aortic arch. This modified arch-first technique is an alternative surgical approach that is used for arch aneurysms involving a shaggy aorta, in order to prevent embolic debris-related complications.
authors.affiliation: Division of Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Naomichi
authors.initials: N
authors.lastname: Uchida
authors.forename: Keijiro
authors.initials: K
authors.lastname: Katayama
authors.forename: Shinya
authors.initials: S
authors.lastname: Takahashi
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
keywords: aberrant right subclavian artery; arch aneurysm; arch-first technique