We present a rare case of common carotid artery with acute type A aortic dissection. A 72-year-old woman underwent emer- gent aortic arch repair using Antegrade selective cerebral protection. Bottom-tapped cannulae were inserted into three orifices of arch vessels, however, regional cerebral oxygen saturation decreased after rewarming. We found that arch branches were in order from front to back, right subclavian artery, common carotid trunk, and left subcravian artery. The patient complicated stroke in the right middle cerebral artery. Keywords Aortic arch anomaly · Vascular ring · Acute type A dissection · Aortic arch repair Introduction sternotomy. After cardiopulmonary bypass (CPB) establish- ment, we started systemic cooling. After the tympanic tem- In most patients with anomaly of aortic arch, surgical proce- perature had decreased to 23 °C and a rectal temperature at dure can be performed safely. However, there are extremely less than 30 °C, the aortic arch was opened, and inserting rare anomalies such as common carotid trunk. We present a perfusion cannulae (Sumitomo, Tokyo, Japan) into three ori- case of type A acute aortic dissection with common carotid fices of arch vessels and antegrade selective cerebral perfu- trunk. sion (ACP) was initiated. We transected the aorta between left carotid artery (LCA) and
General Thoracic and Cardiovascular Surgery – Springer Journals
Published: Jun 4, 2018
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