Re-reconstruction of visceral arteries with thoracoabdominal aortic replacement using a branched graft.

A 44-year-old man, unaffected by Marfan's syndrome, had previously undergone thoracoabdominal replacement for a chronic, type B dissecting aneurysm. Reconstruction of the visceral arteries was performed using an island technique. However, approximately 3 years after the operation, the reconstructed part of the aorta containing the visceral arteries became dilated and an aneurysm formed. We have succeeded both in repairing the aneurysms and "re-reconstructing" the visceral arteries using a branched graft. We conclude that the technique of separate revascularization is worth considering from the beginning, even if the patient does not present with Marfan's syndrome.