Search

Background: In thoracoabdominal aneurysm (TAAA) repair, our technical modification of visceral reconstruction using longer cut pre-sewn side branches has provided good surgical outcomes. Here, we assessed the long-term durability and patency of revascularized branches using computed tomography (CT) to confirm the validity of our approach. Methods: Early and late CT evaluations were performed in 11 TAAA patients (males: 5; mean age: 60.6 years) using the Coselli graft to evaluate the position of main graft and the diverging pattern and patency of side branches. Seven of 11 were sutured in an extra-anatomical fashion using longer cut side branches. Results: In Anatomical (n = 4) and Extra-anatomical (n = 7) groups, the early patency of side branches was not significantly different. Although the late patency of right renal artery (RA) was 100% in both groups, the one of left RA was 60% in Extra-anatomical, while 100% in Anatomical. Furthermore, the main graft in Extra-anatomical was significantly posterior and leftward to the spine with left RA side branch diverging at an acute angle. Conclusions: When a pre-sewn branched graft designed for TAAA is used, the graft should be sutured in a fashion similar to normal patient anatomy to minimize the possibility of kinking of RA side branch for the patency.

The efficacy and safety of surgical intervention for atrial myxoma are established, but the operative approach to tumor resection and atrial reconstruction are controversial. A biatrial approach is generally used for excision of atrial myxoma and has many advantages. In contrast, there are a few reports about the method of double-patch reconstruction, and the right and left atrium are individually reconstructed with the two patches. We found it to be effective in the case reported here. We suggest that this method can be applied to atrial myxoma in which extensive resection is necessary.