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Three-Dimensional Printing of a Complex Aortic Anomaly
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Complex aortic reconstruction using double-barrel frozen elephant trunks.

Neel A Mansukhani1, Andre Y Son2, Eric B Pillado1

  • 1Division of Vascular Surgery, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, IL.

Journal of Vascular Surgery Cases and Innovative Techniques
|February 12, 2026
PubMed
Summary
This summary is machine-generated.

A novel hybrid aortic reconstruction technique was used for a complex chronic type B aortic dissection. This "double-barrel" frozen elephant trunk repair offers a viable solution for challenging aortic arch cases.

Keywords:
Aortic dissectionDouble-barrel frozen elephant trunksFrozen elephant trunkHybrid arch reconstruction

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Aortic Disease

Background:

  • Chronic type B aortic dissection presents complex challenges, including aneurysmal degeneration and limited endovascular options.
  • A 60-year-old patient had a complex dissection with a large entry tear, distal arch aneurysm, and a calcified septum, complicating treatment.
  • Traditional open repairs posed high risks due to patient comorbidities and anatomy.

Purpose of the Study:

  • To describe a hybrid arch reconstruction technique for complex chronic aortic dissection.
  • To present a novel approach using "double-barrel" frozen elephant trunks and thoracic endovascular aortic repair.
  • To evaluate the feasibility of this hybrid technique in a challenging clinical scenario.

Main Methods:

  • A hybrid arch reconstruction involving "double-barrel" frozen elephant trunks was performed.
  • Thoracic endovascular aortic repair was extended to address the distal dissection.
  • The technique aimed to manage the complex anatomy, including the calcified septum and pseudoaneurysm.

Main Results:

  • The hybrid approach successfully addressed the complex chronic aortic dissection.
  • The "double-barrel" frozen elephant trunk technique facilitated reconstruction of the aortic arch.
  • The combined technique allowed for management of the pseudoaneurysm while maintaining true and false lumen flow.

Conclusions:

  • A hybrid arch reconstruction with "double-barrel" frozen elephant trunks and TEVAR is a viable option for complex chronic aortic dissections.
  • This technique may be particularly useful in select patients with challenging anatomy where conventional methods are limited.
  • Further studies are warranted to establish the long-term efficacy and safety of this hybrid approach.