Abstract
A 75-year-old man had sudden congestive heart failure with continuous murmur due to ruptured aneurysm of ductus diverticulum into the pulmonary artery. Patch repair was successfully performed with deep hypothermic selective cerebral perfusion, and adjunctive lower body perfusion through the orifice of the aneurysm. A 71-year-old man with deep shock due to ruptured aneurysm of the aortic arch underwent total aortic arch replace-ment but died of severe brain infarction due to severe atherosclerosis on postoperative day 7. A 72-year-old man with deep shock due to spontaneous rupture of distal aortic arch was successfully operated after diagnosed with repeated computed tomography. Although rupture of the aortic arch is a lethal condition, patients may survive when an urgent operation is performed after appropriate diagnosis and adequate medical support during initial period. Deep hypothermic selective cerebral perfusion is helpful for these patients, but the risk of cerebral embolism due to severely atherosclerotic aorta should be reduced.
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