{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:14:51Z","timestamp":1708906491514},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T00:00:00Z","timestamp":1708819200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T00:00:00Z","timestamp":1708819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Gen Thorac Cardiovasc Surg Cases"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>An aberrant right subclavian artery (ARSA) is the most common congenital variant of the aortic arch and occurs in 0.5\u20131.8% of the population. Most patients with ARSA remain asymptomatic; however, symptoms associated with ARSA include dysphagia, esophageal compression, and airway obstruction. Surgical intervention is indicated if the ARSA becomes symptomatic or is related to aneurysmal dilatation. Even without symptoms, it carries the risk of rupture or dissection, and aggressive surgical therapy is recommended. The coexistence of type B dissection and ARSA is relatively rare, and the cause of this anomaly is unclear; however, some authors have reported that the acute angle of the ARSA weakens the aortic wall, inducing aortic dissection. Several surgical methods, such as thoracic endovascular aortic repair (TEVAR), the frozen elephant trunk method, and open surgery, have been used to manage this lesion. Reconstruction of ARSA is challenging in any surgical procedure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present an uncommon case of coexistent type B aortic dissection and aberrant right subclavian artery (ARSA) in a 72-year-old man. Left anterolateral thoracotomy was chosen to treat the enlarged descending thoracic aortic aneurysm in this case; in situ reconstruction was difficult because the dissection involved the ARSA. Hence, preoperatively, a right common carotid artery (RCCA)-to-ARSA bypass was performed via the right supraclavicular approach, followed by thoracic descending aortic artery reconstruction. The prior RCCA-to-ARSA bypass allowed ligation of the central side of the ARSA, thereby securing a bloodless field in the distal anastomosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This lesion can be successfully repaired by open surgery with a two-stage approach: right common carotid artery-to-ARSA bypass followed by thoracic aortic replacement.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s44215-024-00137-7","type":"journal-article","created":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T21:26:49Z","timestamp":1708896409000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Two-stage surgical treatment of Stanford type B acute aortic dissection associated with aberrant right subclavian artery dissection complicated by distal arch aortic aneurysm and abdominal aortic aneurysm: a case report"],"prefix":"10.1186","volume":"3","author":[{"given":"Yusuke","family":"Shintani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Tobinaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Saisho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Kono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiki","family":"Tayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeaki","family":"Aoyagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Yasunaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,25]]},"reference":[{"key":"137_CR1","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1055\/s-0042-1757948","volume":"11","author":"F Lombardi","year":"2023","unstructured":"Lombardi F, Mamopoulos A, Benedikt J, Katoh M, Kr\u00f6ger K, G\u00e4bel G. How to treat type B aortic dissection in the presence of an aberrant right subclavian artery: a systematic review. Aorta (Stamford). 2023;11:20\u20138.","journal-title":"Aorta (Stamford)."},{"key":"137_CR2","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1016\/j.jvs.2020.01.042","volume":"72","author":"A Plotkin","year":"2020","unstructured":"Plotkin A, Ng B, Han SM, Weaver FA, Ham SW, Bowdish ME, et al. Association of aberrant subclavian arteries with aortic pathology and proposed classification system. J Vasc Surg. 2020;72:1534\u201343.","journal-title":"J Vasc Surg."},{"key":"137_CR3","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1016\/j.athoracsur.2014.05.045","volume":"98","author":"KM Kim","year":"2014","unstructured":"Kim KM, Cambria RP, Isselbacher EM, Baker JN, LaMuraglia GM, Stone JR, et al. Contemporary surgical approaches and outcomes in adults with Kommerell diverticulum. Ann Thorac Surg. 2014;98:1347\u201354.","journal-title":"Ann Thorac Surg."},{"key":"137_CR4","first-page":"407","volume":"111","author":"DK Rasmussen","year":"2011","unstructured":"Rasmussen DK, Dougherty J. Aortic dissection with vascular abnormality. J Am Osteopath Assoc. 2011;111:407\u20139.","journal-title":"J Am Osteopath Assoc."},{"key":"137_CR5","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1007\/BF02665073","volume":"53","author":"K Kikuchi","year":"2005","unstructured":"Kikuchi K, Makuuchi H, Oono M, Murakami H, Suzuki T, Ando T. Surgery for aortic dissection involving an aberrant right subclavian artery. Jpn J Thorac Cardiovasc Surg. 2005;53:632\u20134.","journal-title":"Jpn J Thorac Cardiovasc Surg."},{"key":"137_CR6","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1016\/S0022-5223(19)35702-2","volume":"95","author":"RA Esposito","year":"1988","unstructured":"Esposito RA, Khalil I, Galloway AC, Spencer FC. Surgical treatment for aneurysm of aberrant subclavian artery based on a case report and a review of the literature. J Thorac Cardiovasc Surg. 1988;95:888\u201391.","journal-title":"J Thorac Cardiovasc Surg."},{"key":"137_CR7","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/S0828-282X(08)70552-X","volume":"24","author":"S Singh","year":"2008","unstructured":"Singh S, Grewal PD, Symons J, Ahmed A, Khosla S, Arora R. Adult-onset dysphagia lusoria secondary to a dissecting aberrant right subclavian artery associated with type B acute aortic dissection. Can J Cardiol. 2008;24:63\u20135.","journal-title":"Can J Cardiol."},{"key":"137_CR8","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.jvs.2015.03.038","volume":"62","author":"F Verzini","year":"2015","unstructured":"Verzini F, Isernia G, Simonte G, De Rango P, Cao P, Italian AARSA Collaborative Group. Results of aberrant right subclavian artery aneurysm repair. J Vasc Surg. 2015;62:343\u201350.","journal-title":"J Vasc Surg."},{"key":"137_CR9","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1016\/j.jtcvs.2005.10.012","volume":"131","author":"T Ota","year":"2006","unstructured":"Ota T, Okada K, Takanashi S, Yamamoto S, Okita Y. Surgical treatment for Kommerell\u2019s diverticulum. J Thorac Cardiovasc Surg. 2006;131:574\u20138.","journal-title":"J Thorac Cardiovasc Surg."}],"container-title":["General Thoracic and Cardiovascular Surgery Cases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44215-024-00137-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s44215-024-00137-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44215-024-00137-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T21:28:43Z","timestamp":1708896523000},"score":1,"resource":{"primary":{"URL":"https:\/\/gtcscases.biomedcentral.com\/articles\/10.1186\/s44215-024-00137-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,25]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["137"],"URL":"https:\/\/doi.org\/10.1186\/s44215-024-00137-7","relation":{},"ISSN":["2731-6203"],"issn-type":[{"value":"2731-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,25]]},"assertion":[{"value":"2 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"12"}}