title: A modified "elephant trunk" procedure for aortic arch replacement.
abstract: OBJECTIVE
  We have devised a modified "elephant trunk" technique for primary aortic arch replacement that strengthens the distal anastomosis by preventing access of the blood stream to the distal suture line. The technique entails suturing an elephant trunk graft to the inner surface of the arch graft circumferentially just distal to the fourth of its 4 limbs. The inner graft is then inserted into the distal aortic lumen while the edge of the arch graft orifice is anastomosed to the aortic stump. This clinical trial was conducted to clarify its usefulness.
  
  
  METHODS
  This technique was used in 5 cases of total arch replacement to reinforce distal anastomoses.
  
  
  RESULTS
  All patients tolerated surgery well without complications such as paraplegia or thromboembolism.
  
  
  CONCLUSIONS
  The advantages of this modified technique include simplicity and reproducibility.
authors: Department of Cardiovascular Surgery, Kyorin Medical School, 6-20-2 Shinkawa, Mitaka, Tokyo 180-8611, Japan.
authors: H
authors: H
authors: Ide
authors: T
authors: T
authors: Fujiki
authors: M
authors: M
authors: Sato
authors: K
authors: K
authors: Imamura
authors: H
authors: H
authors: Endo
authors: K
authors: K
authors: Sudo
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D013536:Suture Techniques