Thoracoabdominal aorta replacement with branched graft for visceral and segmental artery reimplantation—case report

: There are various options in the technique of branch vessel reimplantation during thoracabdominal aortic replacement. The choice may affect conduct operation and even surgical outcome especially case low-volume surgeons. This report describes procedural details thoracoabdominal replacement performed a 42-year-old female Marfan patient who had Crawford type II aneurysm caused by chronic B dissection. It stresses our technical tips pitfalls using 4-branch graft including determination adequate length, sequence reimplantation, anastomotic measures organ protection. We also describe novel intercostal artery named ourselves as “frontage graft”. In this technique, target arteries sequentially anastomosed to an 8- or 10-mm which has both ends connected main runs parallel. believe that for visceral advantages such versatility dealing with calcified shaggy aorta, earlier reperfusion individual branches, ease controlling bleeding, prevention late patch aneurysm. experience, frontage used showed better patency rate than end-to-end interposition grafts very low spinal cord ischemia.