TOTAL AORTIC-ARCH REPLACEMENT BY A CRYOPRESERVED AORTIC HOMOGRAFT

The case is presented of a 60-year-old man with previous surgery on th e transverse aorta and a pseudo-aneurysm of the aortic arch and hemopt ysis. The patient was operated upon with cardiopulmonary bypass and ce rebral perfusion, The aortic arch was resected preserving a cuff of th e aorta containing the three supra-aortic trunks, A bronchial fistula was closed with a pediculated flap of the native arch, A long segment of cryopreserved human aorta (ascending, arch and upper descending tho racic aorta) was inserted in the orthotopic position, The aortic cuff with the supra-aortic vessels was re-inserted onto the allograft, The patient is asymptomatic 2 months after the operation, Aortic homograft s are a good alternative in cases with suspected infection or contamin ation, like this one, Other conditions, such as infected aneurysms, in fected grafts, aorto-esophageal fistula and aorto-gastrointestinal fis tula, are potentially good candidates for homografting, We believe tha t this case is the first report of a complete substitution of the aort ic arch with a human cryopreserved homograft.