Clamshell incision plus full sternotomy as a complex approach to complicated aortic arch aneurysm
DOI:
https://doi.org/10.47487/apcyccv.v3i3.225Keywords:
Aortic Aneurysm, Aortic Rupture, Pectus Excavatum, Marfan SyndromeAbstract
Surgical treatment of aortic arch aneurysm is one of the greatest challenges of aortic surgery. We present a young woman with Marfan syndrome, severe Excavated Pectus and previous Bentall procedure, who underwent emergency surgery for ruptured aortic arch aneurysm. We achieved a successful approach through a Clamshell incision associated with a median re-sternotomy.Downloads
References
Coelho SG, Almeida AG. Marfan syndrome revisited: From genetics to the clinic. Rev Port Cardiol (Engl Ed). 2020 Apr;39(4):215-226. English, Portuguese. doi: 10.1016/j.repc.2019.09.008.
Glebova NO, Cameron DE, Black JH 3rd. Treatment of thoracoabdominal aortic disease in patients with connective tissue disorders. J Vasc Surg. 2018;68(4):1257-1267. doi: 10.1016/j. jvs.2018.06.199.
Orozco-Sevilla V, Whitlock R, Preventza O, de la Cruz KI, Coselli JS. Redo Aortic Root Operations in Patients with Marfan Syndrome. Int J Angiol. 2018;27(2):92-97. doi: 10.1055/s-0038-1649485.
Li N, Zhang Y, Gao Y, Bai Y, Qiao F, Tan M, et al. Long-term outcomes of surgical procedures for Marfan syndrome: aortic dissection versus aneurysm. J Thorac Dis. 2020;12(3):249-257. doi: 10.21037/ jtd.2020.01.72.
Schoenhoff FS, Carrel TP. Re-interventions on the thoracic and thoracoabdominal aorta in patients with Marfan syndrome. Ann Cardiothorac Surg. 2017;6(6):662-671. doi: 10.21037/acs.2017.09.14.
Espinoza Saquicela ER, Serrano Olmedo S del C, Espinoza Saquicela ER, Serrano Olmedo S del C. Ascending Aortic Disease in a Patient with Marfan Syndrome. Case reports. 2017;3(2):98-106. doi: 10.15446/cr.v3n2.61493.
y perfusión cerebral anterógrada para la neuroprotección, constituyeron una adecuada estrategia en la cirugía de CA en esta paciente con cirugía cardiaca previa, SM y PE.
Contribuciones de los autores
Los autores participaron equitativamente en la concepción, creación y redacción del presento reporte de caso.
Saeyeldin A, Zafar MA, Velasquez CA, Ip K, Gryaznov A, Brownstein AJ, et al. Natural history of aortic root aneurysms in Marfan syndrome. Ann Cardiothorac Surg. 2017;6(6):625-632. doi: 10.21037/acs.2017.11.10.
Shen J, Gan C, Rajaguru RDT, Yuan D, Xiao Z. Management of a giant aortic root aneurysm in a young patient with Marfan syndrome: a case report. J Cardiothorac Surg. 2020;15(1):264. doi: 10.1186/ s13019-020-01304-x.
Bachet J. Open repair techniques in the aortic arch are still superior. Annals of Cardiothoracic Surgery. 2018;7(3):32844-32344. doi: 10.21037/acs.2018.05.05
Doberne JW, Downey PS, Vekstein AM, Halpern S, Weissler EH, Madou ID, et al. Bilateral Thoracosternotomy (Clamshell Approach) for Complex Aortic Arch Surgery. J Vasc Surg Cases. 2021;74(3):E122. doi: 10.1016/j.jvs.2021.06.187.
Gomibuchi T, Seto T, Yamamoto T, Nakahara K, Ohashi N, Ohtsu Y, et al. Surgical Repair of Cervical Aortic Arch With Brain Circulation Anomaly Through Clamshell Incision. Ann Thorac Surg. 2017;104(3):e235-e237. doi: 10.1016/j.athoracsur.2017.03.075.
Falasa MP, Arnaoutakis GJ, Janelle GM, Beaver TM. Neuromonitoring and neuroprotection advances for aortic arch surgery. JTCVS Tech. 2021;7:11-19. doi: 10.1016%2Fj.xjtc.2020.12.045.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 The journal is headline of the first publication, then the author giving credit to the first publication.
This work is licensed under a Creative Commons Attribution 4.0 International License.