A multidisciplinary multistage complete mega aorta replacement and utilization of extracorporeal membrane oxygenation in thoracoabdominal aneurysm repair

Nallely Saldana-Ruiz; Karanpreet Dhaliwal; Trang N Bodtke; Christopher R Burke; Matthew P Sweet; Sherene Shalhub

doi:10.1016/j.jvscit.2023.101190

A multidisciplinary multistage complete mega aorta replacement and utilization of extracorporeal membrane oxygenation in thoracoabdominal aneurysm repair

J Vasc Surg Cases Innov Tech. 2023 Apr 12;9(3):101190. doi: 10.1016/j.jvscit.2023.101190. eCollection 2023 Sep.

Authors

Nallely Saldana-Ruiz¹, Karanpreet Dhaliwal², Trang N Bodtke², Christopher R Burke², Matthew P Sweet¹, Sherene Shalhub^{3

4}

Affiliations

¹ Division of Vascular Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA.
² Division of Cardiac Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA.
³ Department of Anesthesiology, University of Washington School of Medicine, Seattle, WA.
⁴ Division of Vascular and Endovascular Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR.

Abstract

A 49-year-old woman underwent a 11-month multistage complete replacement of a mega aorta. Replacement stages included ascending aorta and arch replacement in conjunction with a frozen elephant trunk thoracic endovascular aortic repair, extension of thoracic endovascular aortic repair to zone 5, and open repair of the thoracoabdominal aneurysm with the use of venoarterial extracorporeal membrane oxygenation for circulatory support. This case illustrates the complexity of repairing a mega aorta, the multidisciplinary care and staging needed for repair, and the use of peripheral venoarterial extracorporeal membrane oxygenation for circulatory perfusion during thoracoabdominal aneurysm repair.

Keywords: Extracorporeal membrane oxygenation (ECMO); Hybrid aortic repair; Mega aorta; Thoracoabdominal aortic aneurysm; Thoracoabdominal aortic repair.