Phẫu thuật bất thường xuất phát động mạch dưới đòn bên phải bằng kĩ thuật vòi voi đông cứng

Aberrant Right Subclavian Artery (ARSA) represents a rare congenital anomaly that often presents with complex co-morbidities, such as thoracic aortic aneurysm and Kommerell's diverticulum. These intricate vascular pathologies pose significant diagnostic and therapeutic challenges, necessitating advanced surgical strategies to mitigate risks of severe complications like rupture or dissection. The Frozen Elephant Trunk (FET) technique has emerged as a promising, albeit technically demanding, hybrid approach for comprehensive repair of extensive aortic arch diseases. This paper aims to highlight the critical role and successful application of the FET technique in managing a complex case involving ARSA and an associated thoracic aortic aneurysm, thereby providing valuable clinical insights and guiding future therapeutic considerations.

Bác sĩ phẫu thuật tim mạch, chuyên gia mạch máu, bác sĩ tim mạch, và nghiên cứu viên trong lĩnh vực y học tim mạch.

This study presents a detailed case report focusing on the successful surgical management of a 60-year-old male patient diagnosed with an **aberrant right subclavian artery** (ARSA) originating from a dilated aortic arch, further complicated by a significant thoracic aortic aneurysm and Kommerell's diverticulum. Such a constellation of vascular anomalies demands a sophisticated and precise surgical approach due to its inherent complexity and high risk of life-threatening complications. The patient underwent an aortic arch replacement procedure utilizing the **Frozen Elephant Trunk** (FET) technique. This hybrid methodology combined open surgical repair with endovascular stent-graft deployment, effectively covering the diseased aortic segment, repositioning the ARSA to its normal anatomical location, and addressing the Kommerell's diverticulum. The procedural steps involved meticulous cerebral protection strategies and careful anastomoses, contributing to an optimal surgical outcome. Postoperatively, the patient exhibited no complications and demonstrated favorable imaging results, reinforcing the efficacy and safety of the FET technique for these challenging aortic arch pathologies. The paper further discusses the embryological background, diagnostic considerations, and various treatment options for ARSA and coexisting aortic diseases, emphasizing FET's benefits in achieving anatomical reconstruction and preventing long-term adverse events. This case, coupled with a review of relevant literature, enriches the clinical evidence supporting FET as a viable and effective treatment for complex vascular conditions, offering valuable guidance for clinical practice.