Takeuchi Akira, Tsuneyoshi Hiroshi, Katayama Hideyuki, Setozaki Shuji
Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan.
Interdiscip Cardiovasc Thorac Surg. 2025 Feb 5;40(2). doi: 10.1093/icvts/ivaf003.
Cervical aortic arch (CAA) is a rare malformation. Herein, we report a 58-year-old female patient diagnosed with left CAA with descending aortic aneurysm. Initially, the descending aorta replacement was planned via left rib-cross thoracotomy. However, because of intraoperative aortic dissection during mobilization, total arch replacement was performed via emergent median sternotomy first. The main body of the synthetic graft was then guided to the left thoracotomy view, and the peripheral anastomosis of the descending aorta was performed. The surgery was successfully completed. The surgical management of CAA remains unstandardized due to its rarity and complex abnormalities. As aortic wall thinning can easily lead to aortic dissection, careful manipulation is required during mobilization.
颈主动脉弓（CAA）是一种罕见的畸形。在此，我们报告一名58岁女性患者，诊断为左颈主动脉弓合并降主动脉瘤。最初，计划通过左肋横断胸廓切开术进行降主动脉置换。然而，由于在游离过程中出现术中主动脉夹层，首先通过紧急正中胸骨切开术进行全弓置换。然后将人工血管主体引导至左胸廓切开术视野，进行降主动脉的外周吻合。手术成功完成。由于CAA罕见且异常复杂，其手术管理仍未标准化。由于主动脉壁变薄容易导致主动脉夹层，在游离过程中需要小心操作。
