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Extended aortic replacement in acute dissection by the separated elephant trunk technique
T Konishi1, K Higuchi, M Fukata
1Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Japan. konix@muf.biglobe.ne.jp
The Annals of Thoracic Surgery
|July 3, 1999
Summary
This study presents a novel technique for extensive aortic repair in acute dissection, including the aortic arch. The modified elephant trunk method promotes effective thromboexclusion, offering a safer alternative to conventional treatments.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Disease
Background:
- Extensive aortic replacement for acute dissection is not a widely accepted treatment.
- Type A acute aortic dissection poses significant surgical challenges.
Purpose of the Study:
- To describe a safe and effective method for extended aortic repair in type A acute dissection.
- To evaluate the application and outcomes of a modified elephant trunk technique.
Main Methods:
- Development of a modified elephant trunk technique for extended aortic repair.
- Application in 5 cases of type A acute aortic dissection.
- Procedures performed under simple hypothermic circulatory arrest.
Main Results:
- All patients recovered within 2 days with no recurrent nerve injury.
- Postoperative CT showed thrombotic obliteration around the elephant trunk.
- Follow-up CT confirmed progressive thromboexclusion in most patients.
Conclusions:
- The described technique enables extended aortic repair in acute dissection without increased morbidity.
- This method effectively promotes wider thromboexclusion of the dissected lumen compared to conventional approaches.