Combined Aortic Arch Resection for Lung Cancer Using Total Rerouting of Supra-Arch Vessels

Surgery for aortic arch involvement in lung cancer cases is challenging, and generally requires extracorporeal circulation with circulatory arrest or a cerebral protection technique. To reduce morbidity, we developed a novel surgical technique for total aortic arch replacement for lung cancer with aortic arch involvement that features total rerouting of supra-arch vessels under a beating heart condition. A 56-year-old man was diagnosed with lung cancer, and aortic arch invasion was suspected. After concurrent chemoradiotherapy, a left upper lobectomy with total arch replacement was performed using our new technique. Thirty-six months after the operation, there was no recurrence.