European Journal of Cardio-Thoracic Surgery 45 (2014) e125 doi:10.1093/ejcts/ezt642 Advance Access publication 20 January 2014
IMAGES IN CARDIO-THORACIC SURGERY
Type-B interruption of the aortic arch with a giant aortic arch aneurysm in an adult Girish Gowda S.L.a,*, Seetharama P.S Bhata, Devananda Nijagal Shivannaa and Manjunath Cholenahally Nanjappab a b
Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
* Corresponding author. Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka 560069, India. Tel: +91-9449046932; e-mail: [email protected] (G. Gowda S.L.). Received 3 October 2013; received in revised form 27 November 2013; accepted 11 December 2013
Keywords: Interruption of aortic arch • Aortic arch aneurysm • Adult interruption of aortic arch
Figure 1: (A) Preoperative computer tomography anterior view, showing the type-B aortic interruption with the aneurysm arising from the distal segment of the interruption at the level of the left subclavian artery. Innominate vein causing an artefact effect because of its superimposition on the aneurysm. (B) Preoperative computer tomography posterior view, showing the type-B aortic interruption with the aneurysm arising from the distal segment of the interruption at the level of the left subclavian artery. Left subclavian artery origin is dilated and arises from the aneurysm. (C) Diagrammatic representation of the type-B aortic interruption with aneurysm before surgery. A: aneurysm; AA: ascending aorta; DD: descending aorta; RIA: right innominate artery; LCC: left common carotid; LSA: left subclavian artery; X: cross-clamp application site; IV: innominate vein.
computer tomography images and illustrations of the interrupted aortic arch. The aneurysm was excised and continuity established with an interposition graft.
Figure 2: (A) Postoperative computer tomography aortogram showing the anterior view of the interpositioned graft. (B) Postoperative computer tomography aortogram showing the posterior view of the interpositioned graft. (C) Diagrammatic representation of the type-B aortic interruption with aneurysm after surgery. AA: ascending aorta; DD: descending aorta; RIA: right innominate artery; LCC: left common carotid; LSA: left subclavian artery; G: interpositioned graft).
© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
IMAGES IN CARDIOTHORACIC SURGERY
A 21-year old male patient was evaluated for weakness and claudication of both lower limbs. Radio-femoral delay was present on palpation. No intracardiac anomalies showed up on echocardiography. Figures 1 and 2 show preoperative and postoperative
IMAGES IN CARDIO-THORACIC SURGERY
Type-B interruption of the aortic arch with a giant aortic arch aneurysm in an adult Girish Gowda S.L.a,*, Seetharama P.S Bhata, Devananda Nijagal Shivannaa and Manjunath Cholenahally Nanjappab a b
Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
* Corresponding author. Department of Cardiothoracic and Vascular Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka 560069, India. Tel: +91-9449046932; e-mail: [email protected] (G. Gowda S.L.). Received 3 October 2013; received in revised form 27 November 2013; accepted 11 December 2013
Keywords: Interruption of aortic arch • Aortic arch aneurysm • Adult interruption of aortic arch
Figure 1: (A) Preoperative computer tomography anterior view, showing the type-B aortic interruption with the aneurysm arising from the distal segment of the interruption at the level of the left subclavian artery. Innominate vein causing an artefact effect because of its superimposition on the aneurysm. (B) Preoperative computer tomography posterior view, showing the type-B aortic interruption with the aneurysm arising from the distal segment of the interruption at the level of the left subclavian artery. Left subclavian artery origin is dilated and arises from the aneurysm. (C) Diagrammatic representation of the type-B aortic interruption with aneurysm before surgery. A: aneurysm; AA: ascending aorta; DD: descending aorta; RIA: right innominate artery; LCC: left common carotid; LSA: left subclavian artery; X: cross-clamp application site; IV: innominate vein.
computer tomography images and illustrations of the interrupted aortic arch. The aneurysm was excised and continuity established with an interposition graft.
Figure 2: (A) Postoperative computer tomography aortogram showing the anterior view of the interpositioned graft. (B) Postoperative computer tomography aortogram showing the posterior view of the interpositioned graft. (C) Diagrammatic representation of the type-B aortic interruption with aneurysm after surgery. AA: ascending aorta; DD: descending aorta; RIA: right innominate artery; LCC: left common carotid; LSA: left subclavian artery; G: interpositioned graft).
© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
IMAGES IN CARDIOTHORACIC SURGERY
A 21-year old male patient was evaluated for weakness and claudication of both lower limbs. Radio-femoral delay was present on palpation. No intracardiac anomalies showed up on echocardiography. Figures 1 and 2 show preoperative and postoperative
