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European Journal of Cardio-thoracic Surgery 37 (2010) 1233 www.elsevier.com/locate/ejcts Images in cardio-thoracic surgery Endovascular repair of an intra-thoracic ruptured aneurysm of left subclavian artery in a patient with a right-sided aortic arch with aberrant left subclavian artery a b c c, Hwan Wook Kim , Ho Jong Chun , Jong Hui Suh , Jeong Seob Yoon Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Republic of Korea Department of Interventional Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Republic of Korea Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, The Catholic University of Korea, 665-8 Bupyeong 6-dong, Bupyeong-gu, Incheon 403-720, Republic of Korea Received 20 October 2009; received in revised form 24 November 2009; accepted 4 December 2009; Available online 8 January 2010 Keywords: Endovascular repair; Aneurysm of subclavian artery A 55-year-old man was referred with excruciating chest computed tomographic scan (Fig. 1). The ruptured aneurysm pain and syncope. Rupture of an aneurysmal aberrant left was successfully excluded with endovascular stent-graft subclavian artery with right-sided aortic arch was revealed by repair (Fig. 2). Fig. 1. Preoperative computed tomography scan showed an intra-thoracic fusiform ruptured aneurysm of the left subclavian artery and some wall calcifications also with a right-sided aortic arch with aberrant left subclavian artery. The aneurysm was 5.3 cm in maximal diameter and involved from 2.6 cm distal to the origin of the left subclavian artery (A). Emergent arteriogram showed patient’s right-sided aortic arch, aberrant left subclavian artery and ruptured aneurysm of the left subclavian artery (B). LSCA, left subclavian artery. Fig. 2. Completion angiogram showed successful exclusion of the ruptured aneurysm of aberrant left subclavian artery (A). Postoperative computed tomography scan and three-dimensional reconstruction imaging showed successful repair of the ruptured aneurysm of left subclavian artery and anatomical relationship of the supra- aortic vessels with right-sided aortic arch (B). The patient was discharged on the 5th postoperative day without any other complications. LCCA, left common carotid artery; LSCA, left subclavian artery; RCCA, right common carotid artery; RSCA, right subclavian artery; and asterisk, the endovascular stent-graft repaired region. * Corresponding author. Tel.: +82 2 2258 2858; fax: +82 2 594 8644. E-mail address: jsyoon@catholic.ac.kr (J.S. Yoon). 1010-7940/$ — see front matter # 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.ejcts.2009.12.005
European Journal of Cardio-Thoracic Surgery – Oxford University Press
Published: May 1, 2010
Keywords: Keywords Endovascular repair Aneurysm of subclavian artery
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