Surgical reconstruction of the dissected innominate artery using extra-anatomic aorto-axillar bypass

The innominate artery is the most commonly affected supra-aortic vessel in the acute ascending aorta dissection. The brachiocephalic vessels, separated from the true lumen, need reimplantation. The fragile vessel tissue might be challenging to reconstruct. Cerebral blood flow could be restored using an extra-anatomic bypass.

Debranching-first and proximal arch replacement for an innominate artery aneurysm: a case study

The aneurysms of the innominate artery represent a rare form of aneurysmal disease. Management in an early elective basis is recommended due to the risk of stroke and rupture. Treatment options include open surgery, which is the gold standard, and endovascular repair. We describe the debranching-first technique and proximal arch replacement for a huge innominate artery aneurysm and discuss the surgical strategy for cannulation, perfusion and organ protection.