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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
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Beveled reversed elephant trunk procedure for complex aortic aneurysm.

Takuya Fujikawa1, Shin Yamamoto2, Yuji Sekine2

  • 1Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan fujikawa.takuya@gmail.com.

Asian Cardiovascular & Thoracic Annals
|November 20, 2014
PubMed
Summary

A modified elephant trunk technique addresses aortic dissection by using a beveled graft, improving fit and reducing risks in complex aortic arch repairs. This innovative approach ensures a satisfactory repair without neurologic complications.

Keywords:
Aneurysmanastomosisaortic aneurysmaortic diseasesblood vessel prosthesis implantationdissectingsurgicalthoracicvascular surgical procedures

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • The reversed elephant trunk procedure is a technique for managing extensive aortic diseases, involving distal aortic replacement before aortic arch repair.
  • A limitation of the conventional technique is the restriction on the inverted graft's diameter, potentially causing issues in patients with mega aorta or complex anatomy.

Observation:

  • A 54-year-old female patient presented with a severely twisted ascending aortic graft and progressive chronic dissection involving the aortic arch and descending thoracic aorta.
  • The discrepancy between graft diameters posed a challenge for standard surgical repair.

Findings:

  • A beveled reversed elephant trunk procedure was successfully employed to overcome the graft diameter discrepancy.
  • This modification allowed for a more precise and secure anastomosis in the complex aortic anatomy.

Implications:

  • The beveled reversed elephant trunk technique offers a viable solution for complex aortic dissections where graft size mismatch is a concern.
  • This approach can potentially reduce surgical risks and improve outcomes in challenging aortic arch and descending aorta reconstructions.