Simplified Zone 2 Arch Repair Using a Trifurcated Graft for Acute Type a Dissection

Authors

Masashi Kai, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York. Electronic address: masashi.kai@wmchealth.org.
Suguru Ohira, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.
Joshua B. Goldberg, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.Follow
Igor Laskowski, Division of Vascular Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.
Ramin Malekan, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.
Steven L. Lansman, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.
David Spielvogel, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.

Author Type(s)

Faculty

Journal Title

The Annals of Thoracic Surgery

First Page

e67

Last Page

e70

Document Type

Article

Publication Date

7-1-2022

Department

Surgery

Abstract

We report a simplified zone 2 arch repair using a trifurcated graft for acute type A aortic dissection. The right axillary artery is cannulated. After completion of proximal aortic repair using a 1-branched graft, a trifurcated graft is anastomosed to the ascending graft just above the proximal suture line or coronary buttons in case of Bentall procedure. Distal aortic anastomosis is performed at the zone 2 level under unilateral antegrade cerebral perfusion. Full cardiopulmonary bypass flow is resumed via the right axillary artery and ascending graft using both Y-shaped arterial limbs. The left common carotid and innominate arteries are sequentially anastomosed.

Recommended Citation

Kai, M., Ohira, S., Goldberg, J. B., Laskowski, I., Malekan, R., Lansman, S. L., & Spielvogel, D. (2022). Simplified Zone 2 Arch Repair Using a Trifurcated Graft for Acute Type a Dissection. The Annals of Thoracic Surgery, 114 (1), e67-e70. https://doi.org/10.1016/j.athoracsur.2021.09.047