A Hybrid Approach for Thoracic Aortic Arch Aneurysms in Two Patients at High
Operative Risk

Jang, Se Won; Ko, Woo Seok; Kim, Min Jeong; Choi, Jung Cheon; Ahn, Jin Hee; Song, Seung Hwan; Lee, Han Cheol

doi:2014.86.2.218

Korean J Med > Volume 86(2); 2014 > Article

Case Report

The Korean Journal of Medicine 2014;86(2):218-223.
Published online February 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.2.218

A Hybrid Approach for Thoracic Aortic Arch Aneurysms in Two Patients at High Operative Risk

Se Won Jang¹, Woo Seok Ko¹, Min Jeong Kim¹, Jung Cheon Choi², Jin Hee Ahn², Seung Hwan Song³, Han Cheol Lee²

¹Department of Internal Medicine, Good Samsun Hospital, Busan, Korea
²Division of Cardiology, Departments of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
³Thoracic & Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea

고위험군 대동맥궁 동맥류에 대동맥 상부 혈관 우회술과 스텐트 그라프트 치료 2예

장세원¹, 고우석¹, 김민정¹, 최정천², 안진희², 송승환³, 이한철²

^¹좋은삼선병원 내과
^²부산대학교 의학전문대학원 부산대학교병원 순환기내과
^³부산대학교 의학전문대학원 부산대학교병원 흉부외과

Correspondence:
Han Cheol Lee, Tel: +82-51-240-7217, Fax: +82-51-240-7796, Email: glaraone@hanmail.net

Received: 27 November 2012 • Revised: 27 December 2012 • Accepted: 18 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A large aortic aneurysm invading the aortic arch can be catastrophic if rupture occurs. In the past, the standard treatment was an open thoracotomy followed by total aortic arch replacement. However, open surgery is difficult in patients at high operative risk. Consequently, thoracic endovascular aortic repair (TEVAR) is preferred in high-risk patients. In patients with a short proximal landing whose aortic aneurysm invades the aortic arch, TEVAR is not available because of innominate, left carotid, and left subclavian artery occlusion. We report two cases in which aortic aneurysms invaded the aortic arch, and who were treated with TEVAR after a supra-aortic artery bypass operation. (Korean J Med 2014;86:218-223)

Key Words: Aorta; Aneurysm; Stent; Endovascular procedure

주제어: 대동맥궁; 대동맥류; 스텐트; 혈관 내 성형