title: A dual strategic approach to mega-aortic aneurysms.
abstract: Staged resection of mega-aortas with Borst's two-stage elephant trunk (ETK) is the gold standard but has a higher mortality and morbidity compared to single-segment repair. We report the first case of combined surgical and covered-stent approach in Europe. Location and dilatation of the proximal landing zone accounts for the majority of failures in covered-stenting but an ETK is stable, easy to localise and gives an excellent seal. In high-risk cases where surgical resection is not offered, stenting is an option. The lack of a thoracotomy is an advantage in often-frail patients recovering from stage-I and shortens ITU-stay. Therefore, a combined approach is an acceptable alternative in selected individuals.
authors: Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK. wongch@postmaster.co.uk
authors: C H
authors: CH
authors: Wong
authors: M G
authors: MG
authors: Wyatt
authors: R
authors: R
authors: Jackson
authors: A
authors: A
authors: Hasan
mesh_terms: D000368:Aged; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D015607:Stents; D014057:Tomography, X-Ray Computed