Simplified Zone 2 Arch Repair Using a Trifurcated Graft for Acute Type A Dissection.

Kai, Masashi; Ohira, Suguru; Goldberg, Joshua B; Laskowski, Igor; Malekan, Ramin; Lansman, Steven L; Spielvogel, David · Ann Thorac Surg · 2022

case_report · Level V

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Abstract

We report a simplified zone 2 arch repair using a trifurcated graft for acute type A aortic dissection. The right axillary artery is cannulated. After completion of proximal aortic repair using a 1-branched graft, a trifurcated graft is anastomosed to the ascending graft just above the proximal suture line or coronary buttons in case of Bentall procedure. Distal aortic anastomosis is performed at the zone 2 level under unilateral antegrade cerebral perfusion. Full cardiopulmonary bypass flow is resumed via the right axillary artery and ascending graft using both Y-shaped arterial limbs. The left common carotid and innominate arteries are sequentially anastomosed.

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