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A modified "elephant trunk" procedure for aortic arch replacement.

H Ide1, T Fujiki, M Sato

  • 1Department of Cardiovascular Surgery, Kyorin Medical School, 6-20-2 Shinkawa, Mitaka, Tokyo 180-8611, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|July 4, 2001
PubMed
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A modified elephant trunk technique for aortic arch replacement enhances distal anastomosis by protecting the suture line. This simple, reproducible method showed no complications in 5 patients undergoing total arch replacement.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Surgical Innovation

Background:

  • Primary aortic arch replacement is a complex procedure.
  • Ensuring the integrity of the distal anastomosis is critical to prevent complications.
  • Existing techniques may have limitations in reinforcing the distal suture line.

Purpose of the Study:

  • To introduce and evaluate a modified "elephant trunk" technique for primary aortic arch replacement.
  • To assess the safety and efficacy of this technique in strengthening the distal anastomosis.
  • To clarify the clinical usefulness of this innovative surgical approach.

Main Methods:

  • A modified "elephant trunk" graft was sutured to the inner surface of the main arch graft.
  • The inner graft was inserted into the distal aorta, and the arch graft was anastomosed to the aortic stump.

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  • This technique was applied in 5 cases of total aortic arch replacement.

    • Main Results:

    • All 5 patients tolerated the surgical procedure well.
    • No complications, including paraplegia or thromboembolism, were observed.
    • The modified technique effectively reinforced the distal anastomosis.

    Conclusions:

    • The modified "elephant trunk" technique offers a simple and reproducible method for primary aortic arch replacement.
    • This approach enhances the security of the distal anastomosis.
    • The technique appears to be safe and effective in clinical practice.