PMC8057905_01
Preoperative CTA showed transection of the distal aortic arch.
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fig1
II aortic injury). It was located across the origin of the left subclavian artery (Figure 1).
The first arrow indicates a graft anastomosed to the ascending aorta. The second (thin) arrow indicates endograft in the distal arch and the descending thoracic aorta.
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fig2
After completion of partial sternotomy, lowering the blood pressure, a partial clamp was placed on the ascending aorta and an 8 mm Goretex thin-walled, ringed graft was anastomosed in end to side fashion to the aorta (Figure 2).
The proximal end of the chimney graft in the aortic arch.
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fig3
The limb became pale and cold, so a placement of additional Gore Viabahn Endoprosthesis 10 mm x 10cm in the covered LSA was decided (Figure 3).
Postoperative CTA showed the proper position of the chimney graft inside the LSA (arrow) and the patency of the vessel.
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fig4
Postoperative CTA disclosed appropriate position of stent-grafts and adequate flow to the left arm (Figure 4).