title: [Surgical treatment of distal aortic arch aneurysm combined with mitral regurgitation--a case using "elephant trunk" technique and concomitant mitral valvuloplasty].
abstract: We present a surgical case of a 63-year-old male with distal aortic arch aneurysm combined with mitral regurgitation. Through a median sternotomy, a mitral valvuloplasty was performed with McGoon's procedure and Carpentier's ring. Then with the aid of deep hypothermia and circulatory arrest, the aortic arch was opened. A long woven velour graft was anastomosed only proximally to the distal end of the aortic arch and was allowed to float down the descending aorta ("Elephant Trunk" technique). Anti-coagulant therapy was continued only for 4 weeks after the operation. Postoperative left ventriculogram showed no residual regurgitation. The aneurysm was confirmed fully thrombosed around the graft on computed tomogram. It is concluded that "Elephant Trunk" technique for distal arch aneurysm is useful when combined other cardiac surgery without anti-coagulant therapy, such as mitral valvuloplasty, is needed.
authors.affiliation: Department of Cardiovascular Surgery, Yamanashi Prefectural Central Hospital, Kofu, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sakahashi
authors.forename: K
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: S
authors.initials: S
authors.lastname: Hosaka
authors.forename: A
authors.initials: A
authors.lastname: Morishita
authors.forename: Y
authors.initials: Y
authors.lastname: Iida
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D006348:Cardiac Surgical Procedures / Q000379:methods; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*