+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Should the "elephant trunk" be skeletonized? Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection



Should the "elephant trunk" be skeletonized? Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection



Journal of Thoracic and Cardiovascular Surgery 131(1): 107-113



To eliminate the residual false lumen in the descending thoracic aorta and improve long-term outcomes of surgical intervention for Stanford type A aortic dissection, we performed the skeletonized "elephant trunk" procedure in the ascending aorta and aortic arch replacement combined with transaortic stented graft implantation into the descending aorta for both acute and chronic type A aortic dissection, and the short-term results were compared. Between April 2003 and November 2004, 60 consecutive patients (mean age, 53 +/- 16.7; approximate range, 28-78 years) with acute (n = 36) or chronic (n = 24) type A aortic dissection underwent this procedure. Right axillary artery cannulation was used for cardiopulmonary bypass and selected cerebral perfusion. The stented graft, a 10-cm-long woven Dacron graft with a self-expandable stent, was implanted through the aortic arch during hypothermic circulatory arrest. Enhanced electric beam computed tomography was performed in each patient before discharge, 3 months after the operation, and once each year thereafter to evaluate the postoperative time course of the residual false lumen. Cardiopulmonary bypass time was 166 +/- 38 minutes, and average selective cerebral perfusion and lower body arrest time was 30 +/- 15 minutes. The in-hospital mortality was 3.3% (2/60). Thrombus obliteration of the residual false lumen in the descending thoracic aorta was observed in 92% and 85% of the acute and chronic aortic dissections, respectively, 3 months postoperatively. There was no late death during follow-up. The skeletonized elephant trunk procedure is an effective way of closing the residual false lumen of the descending aorta and might contribute to better long-term outcomes for both acute and chronic type A aortic dissection.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 050303078

Download citation: RISBibTeXText

PMID: 16399301

DOI: 10.1016/j.jtcvs.2005.09.015


Related references

Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection. Zhonghua Wai Ke Za Zhi 42(13): 812-816, 2004

Is total arch replacement combined with stented elephant trunk implantation justified for patients with chronic Stanford type A aortic dissection?. Journal of Thoracic and Cardiovascular Surgery 138(4): 892-896, 2009

Strategy of dealing with left subclavian artery in total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection. Zhonghua Wai Ke Za Zhi 49(3): 232-235, 2013

Efficacy comparison between total aortic arch reconstruction with open placement of triple-branched stent graft and total aortic replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection. Zhonghua Xin Xue Guan Bing Za Zhi 40(8): 676-680, 2013

Total arch replacement combined with stented elephant trunk implantation: a new "standard" therapy for type a dissection involving repair of the aortic arch?. Circulation 123(9): 971-978, 2011

Surgery for patients with Marfan syndrome with type A dissection involving the aortic arch using total arch replacement combined with stented elephant trunk implantation: the acute versus the chronic. Journal of Thoracic and Cardiovascular Surgery 142(3): E85-E91, 2011

Total arch replacement with stented elephant trunk technique: a proposed treatment for complicated Stanford type B aortic dissection. Journal of Cardiac Surgery 24(6): 704-709, 2010

Dr. Sun's Procedure for Type A Aortic Dissection: Total Arch Replacement Using Tetrafurcate Graft With Stented Elephant Trunk Implantation. Aorta 1(1): 59-64, 2013

Sun's procedure for chronic type A aortic dissection: total arch replacement using a tetrafurcate graft with stented elephant trunk implantation. Annals of Cardiothoracic Surgery 2(5): 665-666, 2013

Surgery for acute type A dissection using total arch replacement combined with stented elephant trunk implantation: experience with 107 patients. Journal of Thoracic and Cardiovascular Surgery 138(6): 1358-1362, 2009

Surgery for acute type A dissection using total arch replacement combined with stented elephant trunk implantation: Preservation of autologous brachiocephalic vessels. Journal of Thoracic and Cardiovascular Surgery 150(1): 101-105, 2015

Comparative study of the frozen elephant trunk and classical elephant trunk techniques to supplement total arch replacement for acute type A aortic dissection†. European Journal of Cardio-Thoracic Surgery 2019, 2019

Can EuroSCORE II predict the mortality and length of intensive care unit stay after total aortic arch replacement with stented elephant trunk implantation for DeBakey type I aortic dissection?. Thoracic and Cardiovascular Surgeon 61(7): 564-568, 2014

Sun's procedure of total arch replacement using a tetrafurcated graft with stented elephant trunk implantation: analysis of early outcome in 398 patients with acute type A aortic dissection. Annals of Cardiothoracic Surgery 2(5): 621-628, 2013

Modified total arch replacement plus stented elephant trunk implantation in acute type A aortic dissection: open single-branched stent graft placement. Zhonghua Yi Xue Za Zhi 91(48): 3435-3437, 2012