Arteria Lusoria Facilitates Hybrid Management of Aortic Arch Pseudoaneurysm
International Journal of Cardiovascular and Thoracic Surgery
Volume 4, Issue 3, May 2018, Pages: 26-29
Received: Jul. 24, 2018; Accepted: Aug. 6, 2018; Published: Sep. 1, 2018
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Authors
Simon Bejjani, Department of Cardiothoracic Surgery, St Georges Hospital-University Medical Center, University of Balamand, Beirut, Lebanon
Nadine Kawkabani, Department of Cardiac Surgery Anesthesia, St Georges Hospital-University, Medical Center, Beirut, Lebanon
Rula Darwish, Department of Cardiac Surgery Anesthesia, St Georges Hospital-University, Medical Center, Beirut, Lebanon
Omar Boustros, Department of Cardiothoracic Surgery, St Georges Hospital-University Medical Center, University of Balamand, Beirut, Lebanon
Moussa Abi Ghanem, Department of Cardiothoracic Surgery, St Georges Hospital-University Medical Center, Beirut, Lebanon
Bassam Abu Khalil, Department of Cardiothoracic Surgery, St Georges Hospital-University Medical Center, Beirut, Lebanon
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Abstract
Classic open ascending aortic replacement is an effective treatment for Stanford type A aortic dissection However it is associated with a mortality ranging between 15 to 60%. This incidence is even higher in recurrent cases. In these patients, hybrid procedures which combine thoracic endovascular aortic repair (TEVAR) with aortic arch vessel bypasses are successfully adopted. This paper reports a successful hybrid management of aortic arch pseudoaneurysm in a 66 year old female patient known to be hypertensive, diabetic,smoker dyslipidemic on dialysis and who underwent one year previously a surgical ascending aortic repair. Aortic arch vessel bypasses -necessary in this case – were facilitated by the presence of an aberrant right subclavian artery known as Arteria Lusoria- This variant, a rare embryologic anomaly of the aortic arch vessels, described by Hunauld in 1735, was used as an inflow artery to the right common carotid allowing the surgeons to avoid a left to right common carotid artery bypass known to be associated with many complications. Although the hybrid management seems a feasible and safe option especially in high risk patients not eligible for open surgical repair, furher clinical studies and development of new devices dedicated to treat ascending aortic diseases are fundamental to improve outcomes.
Keywords
Aortic Arch Pseudoaneurysm, Hybrid Management, Arteria Lusoria
To cite this article
Simon Bejjani, Nadine Kawkabani, Rula Darwish, Omar Boustros, Moussa Abi Ghanem, Bassam Abu Khalil, Arteria Lusoria Facilitates Hybrid Management of Aortic Arch Pseudoaneurysm, International Journal of Cardiovascular and Thoracic Surgery. Vol. 4, No. 3, 2018, pp. 26-29. doi: 10.11648/j.ijcts.20180403.12
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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