Hybrid operation for a posttraumatic saccular aneurysm of the aortic arch

Ignatiev I.M., Volodyukhin M.Yu., Zanochkin A.V., Terekhin S.V.

Course of Cardiovascular Surgery, Interregional Clinical and Diagnostic Centre Faculty of Advanced Medical Training and Professional Retraining of Specialists Kazan State Medical University Kazan, Russia

The article deals with a case report of successful hybrid surgical treatment of a patient presenting with a posttraumatic large false saccular aneurysm of the aortic arch with mediastinal displacement and compression of the left recurrent laryngeal nerve and trachea.

The patient was subjected to a hybrid operation, i.e., bypass grafting of the brachiocephalic trunk and the left common carotid artery with a bifurcation prosthesis from the ascending aorta through sternotomy, carotid-vertebral and carotid-subclavian bypass grafting on the left in a combination with endoprosthetic repair of the aortic arch with the stent graft Valiant Thoracic 40×224 mm (VAMF 4040c200TE) manufactured by the Medtronic Company. The postoperative period was uneventful followed by rather rapid rehabilitation of the patient.

One month after the operation, the clinical state improved considerably. His voice restored virtually completely, and breathlessness disappeared. According to the findings of MSCT angiography, the aneurysmatic cavity is thrombosed, with the stent graft showing no evidence of either dislocation or endoleak. The bifurcation bypass graft is functioning. According to the data of duplex scanning, the anastomoses established on the neck are patent.

KEY WORDS: posttraumatic aneurysm of the aortic arch, hybrid operation, debranching, endoprosthetic repair.

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