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A modified “elephant trunk” procedure for aortic arch replacement

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Abstract

Objectives: We have devised a modified “elephant trunk” technique for primary aortic arch replacement that strengthens the distal anastomosis by preventing access of the blood stream to the distal suture line. The technique entails suturing an elephant trunk graft to the inner surface of the arch graft circumferentially just distal to the fourth of its 4 limbs. The inner graft is then inserted into the distal aortic lumen while the edge of the arch graft orifice is anastomosed to the aortic stump. This clinical trial was conducted to clarify its usefulness.Methods: This technique was used in 5 cases of total arch replacement to reinforce distal anastomoses.Results: All patients tolerated surgery well without complications such as paraplegia or thromboembolism.Conclusions: The advantages of this modified technique include simplicity and reproducibility.

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References

  1. Borst HG, Frank G, Schaps D. Treatment of extensive aortic aneurysms by a new multiple-stage approach. J Thorac Cardivasc Surg 1988; 95: 11–3.

    CAS  Google Scholar 

  2. Crawford ES, Coselli JS, Svensson LG, Safi HJ, Hess KR. Diffuse aneurysmal disease (chronic aortic dissection, Marfan, and mega aorta syndromes) and multiple aneurysm Treatment by subtotal and total aortic replacement emphasizing the elephant trunk operation. Ann Surg 1990; 211: 521–37.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Svensson LG. Rationale and technique for replacement of the ascending aorta, arch, and distal aorta using a modified elephant trunk produce. J Card Surg 1992; 7: 301–12.

    Article  CAS  PubMed  Google Scholar 

  4. Heinemann MK, Buehner B, Jurmann MJ, Borst HG. Use of “elephant trunk technique” in aortic surgery. Ann Thorac Surg 1995; 60: 2–7.

    Article  CAS  PubMed  Google Scholar 

  5. Emery RW, Arom KV, Nicoloff DM. Modification of the elephant trunk procedure for treatment of acute aortic dissection. J Card Surg 1995; 10: 65–7.

    Article  CAS  PubMed  Google Scholar 

  6. Naka Y, Kadoba K, Ohtake S, Sawa Y, Imagawa H, Nishimura M, et al. Analysis of the elephant trunk method in patients with extensive thoracic aortic aneurysm. Jpn J Thorac Cardiovasc Surg 1999; 47: 607–10.

    Article  CAS  PubMed  Google Scholar 

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Ide, H., Fujiki, T., Sato, M. et al. A modified “elephant trunk” procedure for aortic arch replacement. Jpn J Thorac Cardiovasc Surg 49, 296–300 (2001). https://doi.org/10.1007/BF02913136

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  • DOI: https://doi.org/10.1007/BF02913136

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