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Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
431
[Retrosternal Giant Aortic Aneurysm;Report of Two Cases]
Kazuyoshi Doi1, Manabu Itoh, Takahiro Kitsuka
1Department of Cardiovascular Surgery, Yanagawa Hospital, Yanagawa, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|December 28, 2019
Summary
This study presents a safe surgical strategy for giant retrosternal aortic aneurysms. The technique involves deep hypothermia and left ventricular unloading before aortic aneurysm repair, preventing catastrophic bleeding.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Aneurysm Repair
Background:
- Retrosternal giant aortic aneurysms pose significant surgical challenges due to the risk of catastrophic bleeding.
- Traditional surgical approaches may be limited in managing these complex aortic pathologies.
Observation:
- A 2-case report details the successful surgical repair of retrosternal giant aortic aneurysms.
- The surgical strategy employed deep hypothermia and left ventricular (LV) unloading under cardiopulmonary bypass prior to aortic aneurysm intervention.
- Case 1 involved an 80 mm pseudoaneurysm after prior ascending aorta replacement, managed with LV venting via the pulmonary vein through a ministernotomy.
- Case 2 involved a 66 mm chronic dissecting aneurysm, treated with LV venting via the LV apex through a minithoracotomy.
Findings:
- Both cases underwent successful aortic repair (arch replacement in Case 1, ascending aorta replacement in Case 2).
- The surgical strategy effectively mitigated the risk of bleeding.
- No cardiac, neurological, or other complications were observed in either patient.
Implications:
- This surgical strategy is demonstrated to be safe and effective for complex aortic diseases, specifically retrosternal giant aortic aneurysms.
- The technique offers a viable solution for high-risk aortic aneurysm cases.
- Minimally invasive approaches combined with protective measures like hypothermia and LV unloading enhance surgical outcomes.
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