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Sub total aortic replacement using simultaneous Bentall and elephant trunk procedure.

Mehreen Kisat¹, Umer Darr

¹Medical College, Aga Khan University Hospital, Karachi, Pakistan.

JPMA. the Journal of the Pakistan Medical Association

|February 24, 2012

Summary

This study reports a complex aortic surgery in a young female patient, involving extensive aortic grafting from the root to the descending aorta. The successful simultaneous application of Bentall and Elephant Trunk techniques is a novel approach in Pakistan.

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Area of Science:

Cardiovascular Surgery
Thoracic Aortic Surgery
Aortic Aneurysm Treatment

Background:

A 22-year-old female presented with severe valvular heart disease, including moderate mitral and aortic insufficiency.
The patient also had extensive aneurysmal dilatation affecting the ascending aorta, aortic arch, and descending aorta.

Observation:

The surgical team performed a complete anterior aortic replacement.
This involved aortic root and valve replacement using a composite graft with coronary artery reimplantation (Bentall and De Bono technique).
Simultaneously, a graft replacement of the transverse arch and descending aortic aneurysms was executed using the Elephant Trunk technique.

Findings:

The surgical procedure successfully addressed multiple sites of aortic disease in a single operation.

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This extensive aortic grafting procedure, combining Bentall and Elephant Trunk techniques, represents a first in Pakistan.

Implications:

This case demonstrates the feasibility of complex, multi-segment aortic reconstruction in young patients.
The simultaneous application of these advanced surgical techniques offers a potential solution for extensive aortic pathologies.
Highlights the growing capacity for complex cardiovascular surgeries in Pakistan.