A new inclusion technique through an upper partial sternotomy for complicated Stanford B-type aortic dissection with an aberrant right subclavian artery: A case report. Issue 11 (March 2019) - Huang, Maoxun
Abstract: Rationale: An aberrant right subclavian artery (ARSA), arising from the proximal descending aorta, is a common aortic arch anomaly, with an incidence of 0.5% to 2%. However, coexistence of dissection and an ARSA is extremely rare. We presented the first case of successful management of complicated Stanford B-type aortic dissection combined with an ARSA with a new inclusion technique and stent graft (SG) implantation through an upper partial sternotomy. Patient concerns: A 39-year-old woman with a history of severe hypertension was admitted to our hospital because of sudden-onset chest and upper back pain. Diagnoses: Aortic computed tomography angiography (CTA) demonstrated complicated Stanford B-type dissection with ARSA. Interventions: A new inclusion technique and SG implantation through an upper partial sternotomy were performed for the patient, whose aortic arch branch vessels, including ARSA, were fully preserved. Outcomes: The patient had an uneventful postoperative course without neurologic deficits, and no blood transfusion was required during the hospitalization. The false lumen completely disappeared on postoperative CTA. Lessons: This new inclusion technique through an upper partial sternotomy is a safe and feasible treatment for complicated Stanford B-type aortic dissection with an ARSA with the primary tear located in the aortic arch.