[Prosthetic repair of the ascending aorta and aortic arch from the left-sided thoracotomy in a female patient after pulmonectomy (clinical case report)].

Described herein is a clinical case of successful prosthetic repair of the aortic valve, ascending aorta and aortic arch according to the hemiarch technique from the left-sided thoracotomy. A 69-year-old female patient presented with an aneurysm of the ascending aorta and proximal aortic arch, a combined defect of the aortic valve and pronounced displacement of the mediastinal organs due to pulmonectomy performed in 2001. The classical procedure of the operation from the median sternotomy would be associated with technical difficulties and a high risk of lung injury owing to displacement of the mediastinum to the left, therefore left-sided lateral thoracotomy was chosen, thus making it possible to perform full-scope surgical treatment without exposure deterioration. The woman was discharged with no complications on POD 7 and rapidly rehabilitated. Precise knowledge of the anatomical location of the aorta and cardiac structures plays a large part in planning of the operation. That is why it is necessary to underline the importance of thorough preoperative CT planning prior to interventions on the thoracic portion of the aorta, with the use of alternative approaches in non-standard anatomy making it possible to avoid unexpected difficulties and complications during interventions on the thoracic aorta.