Descending aorta to carotid bypass for takayasu arteritis as a redo operation

In Takayasu arteritis recurrent brain ischemia, due to bypass graft failure, is frequent. Redo bypass grafting from the ascending aorta may be at risk if a failing but patent graft that is critical for brain blood flow is present, because partial clamping the ascending aorta may disturb graft flow if the ascending aorta is short. We report such a patient who successfully underwent redo bypass grafting from the descending aorta. In type I Takayasu arteritis, this operation may be valuable because the descending aorta is usually disease free and brain blood flow is maintained during the operation.