[Simultaneous surgical treatment for distal aortic arch aneurysm associated with innominate artery aneurysm and coronary artery disease].

The patient was 69-year-old male who admitted to our hospital in November 1995 with the complaint of abnormal shadow on chest C-ray. CT scan and aortogram revealed aneurysms of the distal aortic arch and innominate artery. Seventy-five percent stenosis of the right coronary artery was also found in coronary angiogram. The total arch replacement and reconstruction of the innominate artery and CABG to right coronary artery were performed with the aid of cold blood cardioplegia and selective cerebral perfusion and open distal anastomosis. Ascending aorta was used for arterial cannulation to avoid the thromboembolism due to retrograde perfusion from the femoral artery. Satisfactory postoperative course was obtained except transient left hemiplegia and post operative three-dimensional CT scan demonstrated the successful reconstruction. The patient was doing well 8 months postoperatively.