Related Experiment Video
Updated: Mar 20, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
[Surgical Procedure Using the Elephant Trunk Technique at All Anastomotic Sites for Acute Type A Aortic Dissection]
Koji Hashizume1, Mizuki Sumi, Kazuyoshi Tanigawa
1Department of Cardiovascular Surgery, Nagasaki Harbor Medical Center, City Hospital, Nagasaki, Japan.
Objective:
We report the use of the elephant trunk technique at all anastomotic sites in acute type A aortic dissection surgery.
Methods:
Artificial graft carrying a 2-mm short elephant trunk were prepared for both distal and proximal anastomotic sites. Subjects were 82 patients with acute type A aortic dissection who underwent surgery using this procedure between March 2009 and August 2015. The mean age was 69.6 ±10.7 years( range, 43~89 years). Seventeen patients( 20.7%) had cardiac tamponade or shock, while 8 cases( 9.8%) had organ ischemia due to malperfusion.
Results:
Total aortic arch replacement was performed in 22 patients (26.8%), while replacement of the ascending aorta was performed in 60( 73.2%). The mean durations of surgery, extracorporeal circulation, and cardiac ischemia were 352 ± 64, 199 ± 37, and 123 ± 26 min, respectively. Five in-hospital deaths( 6.1%) occurred. With respect to early complications, 5 patients( 6.1%) had permanent encephalopathy. Nine (11.0%) had respiratory failure, and 4 (4.9%) required tracheotomy. None of the patients had bleeding requiring additional thoracotomy for hemostasis and none had complications attributed to preparation of the artificial vessels.
Conclusion:
Artificial graft were prepared using the elephant trunk technique for use at all anastomotic sites in acute type A aortic dissection surgery. This procedure, involving stepwise proximal anastomosis, is highly effective for hemostasis and safe.
