title: Real chimney technique for total debranching of supra-aortic trunks.
abstract: Side-clamping of the ascending aorta is an indispensable technique for proximal anastomosis in total debranching of supra-aortic trunks and in endovascular aneurysm repair for arch aneurysm. However, this procedure may lead to the dislodging of multiple plaques and to clamp injury of the ascending aorta. We developed a clampless technique to achieve proximal anastomosis between the ascending aorta and an artificial graft used for total debranching of supra-aortic trunks. We applied this method in six patients with arch aneurysm and a plaque-rich ascending aorta and were able to achieve total debranching of the supra-aortic trunks in all of the patients without side-clamping the ascending aorta and no procedurally related complications. This clampless anastomosis technique ("real chimney technique") in the ascending aorta is a valuable option for total debranching of supra-aortic trunks in the hybrid repair of arch aneurysms.
authors.affiliation: Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan. Electronic address: mkat03@gmail.com.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kagaya
authors.affiliation: Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Kubo
authors.affiliation: Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Banno
authors.affiliation: Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ohkubo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D050197:Atherosclerosis / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D003250:Constriction; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D058226:Plaque, Atherosclerotic; D011474:Prosthesis Design; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome