Alternative method of surgical reconstruction of thoracoabdominal aorta

• Marchenko A.V.
• Myalyuk P.A.
• Petrishchev A.V.
• Arutyunyan V.B.
• Orekhova E.N.
• Kadyraliev B.K.
• Musaev O.G.
• Vronskiy A.S.
• Sinelnikov Yu.S.

Abstract

Presented herein is a clinical case report regarding surgical reconstruction of the thoracoabdominal aorta according to a new method aimed at reducing the time of ischemia of visceral organs. The procedure began with distal bypass of the iliac arteries, followed by sequential debranching of the left renal artery, superior mesenteric artery, and celiac trunk in the presence of natural blood circulation without aortic cross-clamping. And it was only at the stage of prosthetic repair of the right renal artery and intercostal arteries that the left ventricular bypass (pulmonary vein – branch of the prosthesis) was added, with the aorta cross-clamped and opened. The final step was a proximal anastomosis at the level of the aortic isthmus.

The proposed new method of surgical reconstruction of the thoracoabdominal aorta makes it possible to decrease the duration of aortic cross-clamping, artificial circulation, ischaemia of the visceral organs and spinal cord, thus directly contributing to the improvement of surgical treatment outcomes in this cohort of severely ill patients.

Keywords:thoracoabdominal aortic aneurysm; aortic dissection; prosthetic repair of the thoracoabdominal aorta; surgical reconstruction of the thoracoabdominal aorta; visceral debranching