Simultaneous operation of intra-descending aorta bypass grafting and brachiocephalic artery reconstruction in a patient of aortitis syndrome

A 42-year-old woman underwent concomitant intra-descending aorta bypass grafting and brachiocephalic artery reconstruction successfully. She was diagnosed as aortitis syndrome with brachiocephalic artery obstruction, severe stenosis of descending aorta and stenosis of right upper renal artery. Chief complaint was chest oppressive feeling, but none of brain nor upper extremity ischemia. Catheterization showed 100 mmHg pressure gradient across stenosis of descending aorta and 100 mmHg pressure gradient between ascending aorta and right brachial artery. In order to relieve hypertension and prevent right head and upper extremity ischemia, concomitant vascular reconstruction was performed using woven Dacron prostheses. Hypertension had subsided postoperatively, and she was relieved from any symptom.