Total arch replacement with endarterectomy of the ascending aorta in a patient with aortic arch aneurysm and porcelain aorta

Hideyuki Shimizu, Yasuko Miyaki, Tsuyoshi Kaneko, Ryo Suzuki, Mikihiko Kudo, Ryohei Yozu

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We describe total arch replacement for aortic arch aneurysm with a severely calcified ('porcelain') aorta. Cardiovascular surgery is challenging under such conditions because the calcified plate interferes with clamping, incising, and suturing of the aorta. We performed this surgery under hypothermic circulatory arrest with antegrade cerebral perfusion. Calcification manifested particularly in the ascending aorta and prevented the use of a needle. We exfoliated the calcified intimal plate using an elevator designed for hand surgery, and then covered both the inner and outer sides of the endarterectomized aorta with a strip of bovine pericardium to reinforce the anastomotic region and cover the rough surface. No complications developed during or after surgery. (Ann Thorac Cardiovasc Surg 2008; 14: 402-404).

Original languageEnglish
Pages (from-to)402-404
Number of pages3
JournalAnnals of Thoracic and Cardiovascular Surgery
Issue number6
Publication statusPublished - 2008 Dec



  • Aortic arch
  • Atherosclerotic aortic aneurysm
  • Calcification
  • Hemodialysis

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Gastroenterology
  • Medicine(all)

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