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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2007 December;48(6):805-7

language: English

Identification of proximal landing zone limit for proper eployment of aortic arch stentgraft after supra-aortic great vessels transposition

Serag A. R. 1, Bergeron P. 2, Mathieu X. 2, Piret V. 2, Petrosyan A. 3, Gay J. 2

1 Department of Cardiothoracic Surgery Faculty of Medicine, Tanta University Tanta, Egypt
2 Department of Thoracic and Cardiovascular Surgery Saint-Joseph’s Hospital Marseille, France
3 Yerevan State Medical University Yerevan, Armenia


The proper identification of the proximal landing zone prior to aortic stentgraft deployment is a key step that impacts the global outcome of the procedure. We report an intraoperative technique during total aortic arch transposition that facilitates subsequent endovascular arch exclusion thanks to a reliable radio-opaque marker. In patients who require an endovascular exclusion of the aortic arch, a total arch transposition can be performed through a median sternotomy prior to stentgraft deployment. During the surgical stage, a radio-opaque thread is pull out of a surgical sponge pad, looped around the ascending aorta just distal to the ostium of the aorto-innominate bypass and fixed in place by means of metal clips. The technique we describe increases the accuracy of stentgraft deployment in the ascending aorta after total arch transposition. It will potentially improve the outcome.

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