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Updated: May 10, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Modified arch-first technique performed on a beating heart for an arch aneurysm with atheromatous plaques
Naomichi Uchida1, Keijiro Katayama, Shinya Takahashi
1Division of Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Abstract:
A shaggy aorta with unstable atheromatous plaques has a high risk of neurologic complications in cases of arch aneurysm. We report the use of a modified arch-first technique involving arch replacement for a beating heart after reconstruction of supra-aortic vessels while maintaining normal blood pressure. The procedure was performed in a patient who had an arch aneurysm, complicated by an aberrant right subclavian artery (ARSA) and a shaggy aorta ascending to the aortic arch. This modified arch-first technique is an alternative surgical approach that is used for arch aneurysms involving a shaggy aorta, in order to prevent embolic debris-related complications.
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