Simplified thoracic aortic aneurysm repair

Descending thoracic and thoracoabdominal aortic operations still represent a challenge for the cardiovascular surgeon. In recent years, endovascular stent grafting has become a popular alternative to a conventional operation in selected patients, but is not always readily available or is technically contraindicated; also, long-term results are unknown. We describe a simplified surgical technique to secure a standard vascular prosthesis by performing a modified "elephant trunk" operation and discuss potential indications for its application.