One-Stage Repair of a Thoracoabdominal Aortic Aneurysm Associated with Infrarenal Aortic Occlusion and Visceral Artery Stenosis Using a Modification of the Standard Atriofemoral Bypass Technique

Abstract

Thoracoabdominal aortic aneurysms (TAAA) are associated infrequently with visceral artery occlusive disease and rarely with aortoiliac occlusion. The presence of occlusion of the infrarenal abdominal aorta limits the options for visceral artery perfusion and spinal cord protection by means of distal aortic perfusion and, consequently, increases the risk for postoperative complications and mortality. Significant stenoses of the visceral arteries further add to the complexity of the repair. We describe a one-stage repair of a type I TAAA associated with infrarenal aortic occlusion and significant stenoses of all visceral arteries using a modified distal perfusion technique.