Journal «Angiology and Vascular Surgery» • 

2015 • VOLUME 21 • №2

Hybrid surgical intervention in a patient with an aortic arch aneurysm and coronary artery disease

Charchan E.R.1, Abugov S.A.1,2, Puretsky M.V.1,2, Kim S.Yu.1, Skvortsov A.A.1, Khachatryan Z.R.1

1) Department of Surgery of the Aorta and its Branches, B.V. Petrovsky Russian Research Centre of Surgery under the Russian Academy of Medical Sciences,
2) Department of Roentgenosurgical (Roentgenoendovascular) Methods of Diagnosis and Treatment under the Russian Medical Academy of Postgraduate Education, Moscow, Russia

Presented herein is a clinical case report regarding the use of hybrid technology in surgical treatment of a patient with an aneurysm of the distal portion of the aortic arch and coronary artery disease.

The patient underwent a hybrid operation, i.e. debranching of the aortic arch branches, exoprosthetic repair of the ascending aorta, autovenous prosthetic coronary bypass grafting of the branch of the blunt edge of the anterior interventricular artery, stenting of the ascending portion, arch and descending portion of the aorta (stent graft “Medtronic Valiant”). In doing so, we used a non-standard approach to connecting the artificial circulation unit and to choosing the place for establishing proximal anastomoses of autovenous coronary bypass grafts.

The early postoperative period was complicated by the development of respiratory insufficiency requiring continuation artificial pulmonary ventilation. The duration of the hospital stay of the patient amounted to 15 days. The check-up multispiral computed tomography showed normal functioning of the reconstruction zones, the stent graft is expanded, with no leak observed.

The conclusion was made that hybrid interventions may be considered as an alternative to the classical surgical treatment associated in patients of older age group with a severe course of the postoperative period and high lethality.

KEY WORDS: aortic arch aneurysm, CAD, hybrid operation, aortic stenting, stent graft, debranching.

P. 182

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