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Eur J Cardiothorac Surg 2000;18:246-248
© 2000 Elsevier Science NL

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A novel modification of elephant trunk technique using a single four-branched arch graft for extensive thoracic aortic aneurysm

Department of Cardiovascular Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Sakai 591-8025, Japan

Received 8 September 1999; received in revised form 17 February 2000; accepted 23 May 2000.

Corresponding author. Tel.: +81-722-52-3561; fax: +81-722-50-7540
e-mail: skuki{at}orh.go.jp

Surgical repair for the extensive thoracic aortic aneurysm remains unsatisfactory, especially in elderly patients. We developed a total arch replacement with modified elephant trunk technique under moderately hypothermic cardiopulmonary bypass and selective brain perfusion, in which a 4-branched arch graft with a sewing ‘collar’ enabled the distal anastomosis just proximal to the innominate artery with open distal method and a long ‘elephant trunk’ was inserted into the descending aorta by the forceps catheter via the femoral artery. This modification is easy and less invasive, and reduces the risk of postoperative complications.

Key Words: Thoracic aneurysm • Arch replacement • Elephant trunk • Selective brain perfusion

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