Abstract
The patient was a 64-year-old man who had aortic regurgitation, ischemic heart disease, a transverse aortic aneurysm, and an abdominal-common iliac aneurysm. Concomitant operations including aortic valve replacement, coronary artery bypass grafting, and total aortic arch replacement with elephant trunk technique were performed successfully. The patient developed postoperative cardiac tamponade on the 5th postoperative day, resulting in bulbar palsy due to occlusion of the dominant left vertebral artery. Thrombectomy of the vertebral artery with reconstruction by a saphenous vein was performed. The patient’s neurological symptoms improved after the operation. Revascularization of ischemic stroke may yield neurological improvement even in patients after cardiovascular surgery.
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11748_2019_1106_MOESM1_ESM.tiff
Preoperative CT. a, 3D CT of the aorta; b, transverse aortic arch aneurysm; c, abdominal aneurysm; d, right common iliac artery aneurysm (TIFF 1521 KB)
11748_2019_1106_MOESM2_ESM.tiff
Intraoperative fluoroscopy during left vertebral artery thrombectomy. The white arrow indicates the inflated Fogarty 4F balloon at the middle portion of the left vertebral artery (a) and at the proximal portion of the left vertebral artery (b); c, extracted thrombi (TIFF 1521 KB)
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Aoki, C., Fukuda, I., Watanabe, Ki. et al. Thrombectomy and reconstruction of the left vertebral artery after total arch replacement: never give up on postoperative stroke. Gen Thorac Cardiovasc Surg 68, 534–537 (2020). https://doi.org/10.1007/s11748-019-01106-6
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DOI: https://doi.org/10.1007/s11748-019-01106-6