A case of the ascending aorta and aortic arch replacement with thrombo-occlusion of distal arch and descending aorta suround the modified elephant trunk graft

1998 ◽  
Vol 46 (10) ◽  
pp. 1065-1068
Author(s):  
Kazuhisa Rikitake ◽  
Naoki Minato ◽  
Junichi Murayama ◽  
Hiroyuki Ohnishi
Keyword(s):  
Aortic Arch ◽  
Ascending Aorta ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Descending Aorta

scholarly journals A Case of Replacement of the Ascending Aorta, Transverse Aortic Arch, Descending Aorta, and Upper Abdominal Aorta Using the "Elephant Trunk" Operation.

1994 ◽  
Vol 23 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Norihiko Shiiya ◽  
Keishu Yasuda ◽  
Jun'ichi Oba ◽  
Masatoshi Miyama ◽  
Michiaki Imamura ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Abdominal Aorta ◽  
Ascending Aorta ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Upper Abdominal

scholarly journals Early Results of a Novel Single-Stage Hybrid Aortic Arch Replacement Technique to Reduce Bypass and Circulatory Arrest Duration

2020 ◽  
Vol 23 (2) ◽  
pp. E107-E113
Author(s):  
Castigliano Murthy Bhamidipati ◽  
Jay D Pal
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Aortic Arch ◽  
Stent Graft ◽  
Circulatory Arrest ◽  
True Lumen ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Descending Aorta ◽  
The Mean

ABSTRACT Objective: Hybrid repair procedures of the aortic arch have been utilized to reduce surgical risks and apply this therapy to patients who would not traditionally be candidates for open surgical repair.  We present a variation on the frozen elephant trunk technique to further reduce cardiopulmonary bypass and circulatory arrest duration. Methods: After initiation of cardiopulmonary bypass and during systemic cooling, a wire is advanced from the femoral artery into the aortic arch.  In the case of aortic dissection, intravascular ultrasound is used to confirm true lumen placement.  Under circulatory arrest, the proximal aortic arch is resected and the wire externalized.  Antegrade deployment of a stent graft is performed into the aortic arch and proximal descending aorta.  The ascending aortic graft is sewn to the cut end of the aorta, incorporating the stent graft.  The graft is cannulated and cardiopulmonary bypass reinitiated.  The remainder of the arch replacement is performed during re-warming. Results: Twenty two patients underwent this novel hybrid arch replacement procedure for aortic pseudoaneurysm, aortic dissection, or aneurysm.  In comparison to the frozen elephant trunk procedure, where a dacron graft is inserted into the descending aorta, and later fixed with an endograft, this technique allows for immediate distal fixation.  In the case of aortic dissection, there is immediate expansion of the true lumen with distal seal, potentially obviating the need for additional procedures.  Mean duration of follow up is 12 months (range 1 – 14 months).  The mean duration of cardiopulmonary bypass was 109.32 ±3.14 minutes.  The mean duration of circulatory arrest was 18.00 ±1.33 minutes at a mean temperature of 23.64 ±0.58 degrees Celsius.  There were no mortalities, no permanent disabling strokes, and no renal failure (requiring dialysis). Conclusions: This novel hybrid technique for aortic arch replacement is safe, significantly reduces cardiopulmonary bypass and circulatory arrest times, and is performed readily without need for fluoroscopy.  In patients with thoracoabdominal aneurysms, the stent graft can be used as an elephant trunk for further thoracoabdominal aneurysm repair or branched thoracic endovascular aortic repair procedures.  

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

Total Aortic Arch Replacement and Frozen Elephant Trunk

2020 ◽  
Author(s):  
Jacky Y.K. Ho ◽  
Simon C.Y. Chow ◽  
Micky W.T. Kwok ◽  
Takuya Fujikawa ◽  
Randolph H.L. Wong
Keyword(s):  
Aortic Arch ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement

Aneurysm Hybrid Treatment by Simultaneous Replacement of Ascending Aorta and Aortic Arch and Endoluminal Stenting of the Descending Aorta

2006 ◽  
Vol 9 (1) ◽  
pp. E530-E532
Author(s):  
Friedrich-Christian Riess ◽  
Hans Krankenberg ◽  
Thilo Tübler ◽  
Matthias Danne
Keyword(s):  
Aortic Arch ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Hybrid Treatment
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