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Korean Circ J. 2012 May;42(5):360-365. English. Case Report. https://doi.org/10.4070/kcj.2012.42.5.360
Lee KN , Lee HC , Park JS , Kim BW , Cha KS , Kim SP , Lee CW , Kim HK .
Department of Cardiology, Pusan National University College of Medicine, Busan, Korea. glaraone@hanmail.net
Department of Thoracic and Cardiovascular Surgery, Pusan National University College of Medicine, Busan, Korea.
Department of Anesthesia, Pusan National University College of Medicine, Busan, Korea.
Abstract

While thoracic endovascular aortic repair is an effective treatment option for descending thoracic aorta pathology, it does have limitations. The main limitation is related to the anatomical difficulties when disease involves the aortic arch. A fenestrated, branched aortic stent graft and hybrid operation has been introduced to overcome this limitation, but it is a custom-made device and is time consuming to manufacture. Furthermore, these devices cannot be used in an emergency setting. We report two patients with massive descending thoracic aortic aneurysm and ruptured aortic dissection very near the aortic arch who underwent a procedure which we named the modified chimney technique. The modified chimney technique can be used as a treatment option in such an emergency situation or as a rescue procedure when aortic pathology is involved near the supra-aortic vessels.

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