There are always patients where their approximate Rettig your dick pathology starts more proximately like in this patient who also had an eighth-inning ojek aneurysm and exceptionally Leanne deathless chaotic one with multiple penetrating adult erotic ulcers what we did and was in a sending autók replacement we call this a normal thermic total arch repair perfusionist by a side branch to the right subclavian artery a clamp is being put at the level of the brackets of electron conditioning orders being replaced and in the next step you may add either double transposition like in that case and read see
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There multiple lacerations in the bracket cephalic trunk or total re-routing a dependent on to the individual situation in this particular case we use double transposition as you can see here and in a few minutes and you will see the insertion of the same craft due to the obliterated itary ography of the disease in this patient and the exits via did via the external iliac artery was insufficient and so we went for retroperitoneal approach to put a 9 millimeter prosthesis of the common iliac artery and then advanced this then craft with a proximal tip capture.
Shat we feel is important within the allergic arch at the level at the offspring of the brackets you valdakk track and you can see the deployment of the proximal graft here and the distal graft with a luxury overlapping so because we feel this is very important to gain sufficient sealing distally in a few moments you will see the completion and geography with regular super erotic perfusion of double transposition distant graft in place as well there’s no signs of any kind of in the leakage and as you can see we also replaced the old Iguala with the bioprosthesis due to land middle grade or dick stenosis
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