Total arch replacement for intrathoracic left subclavian artery aneurysm; report of a case

A 65-year-old man with left subclavian artery aneurysm, detected by enhanced computed tomography (CT), was referred to our hospital. The CT revealed intrathoracic left subclavian artery aneurysm (maximum diameter, 5 cm) at the takeoff of the aortic arch. Surgery was indicated considering the risks of rupture and embolism. The aneurysm was exposed through median sternotomy. Cardiopulmonary bypass was established with cannulation of the right axillary artery, left femoral artery, superior vena cava (SVC), and inferior vena cava (IVC). Circulatory arrest and isolated cerebral perfusion were achieved at a core temperature of 23 degrees C. Total arch replacement was performed using a 26 mm 4-branched Triplex graft, and the left subclavian artery was reconstructed by branch-left axillary artery bypass. The postoperative course was uneventful. He was discharged on the 22nd postoperative day.