DESCRIPTION OF AUGUSTO’S SURGERY

TO REPAIR THE AORTA’S INJURY

PERFORMED IN 10-21-11

BY DR.  MARK FELGER AND DR. SCOTT SEIDEL

UNIVERSITY MEDICAL CENTER-BRAKENRIDGE-SETON

AUSTIN, TEXAS

Introduction:  Endovascular repair is a relatively new procedure to repair aortic aneurisms or traumatic injury without the need to open the chest.  In this particular case, the surgical procedure required two separate procedures. Due to the location of the aortic tear, on the inner side of the aortic arch, the insertion of the Thoracic Endoprosthesis (the stent) will block the “outlet” of the subclavian artery, which provides blood to the left arm. Therefore, the first procedure is to make a by-pass between the “left common carotid” artery feeding the brain and the subclavian, which will be locked. This also was done without opening the chest cavity; it was performed through the area of the neck just above the clavicle bone.

Once this was completed, an incision was made in the inguinal area and the left inguinal artery, where the doctor introduced the “Gore-Tag” (commercial name of the stent used) and drove it up to where the two inguinal arteries form the abdominal aorta, and continued up to the thoracic aorta (an arch, see drawing below). The device is then deployed, expanding all around and giving support to the injured artery, which will in time repair itself with its own tissue. The following sketch depicts the procedure.