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\begin{document}

\title{Extended aortic arch repair via simple median sternotomy using a
parabronchial approach: a case report}



\author[1]{Ryosuke Kowatari}%
\author[1]{Hanae Sasaki}%
\author[1]{Shiho YamazakiMD}%
\author[1]{Kazuyuki Daitoku}%
\author[1]{Masahito Minakawa}%
\affil[1]{Hirosaki Daigaku}%


\vspace{-1em}



  
  \date{March 12, 2025}


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\begin{abstract}
Surgery for extensive thoracic aortic aneurysms is challenging. We
report the case of a young woman with Takayasu's arteritis who developed
aortic dissection and was successfully treated with our novel extended
arch repair method, which we termed ``parabronchial approach''. Surgery
was performed via a simple sternotomy. The left pulmonary artery was
compressed caudally by a surgical assistant arm typically used for
coronary artery bypass grafting. This method simplified the creation of
a distal anastomosis to the descending aorta behind the left bronchus.
Postoperative computed tomography revealed a distal anastomosis at the
sixth thoracic vertebra \textsubscript{.} This parabronchial approach
could reduce the frequency of choosing a highly invasive approach and
can be a potential minimally invasive approach in cases requiring
extensive thoracic aortic aneurysm repair.%
\end{abstract}%



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