title: [Adequate size of elephant trunk in the procedure of total arch replacement for acute aortic dissection].
abstract: Total aortic arch replacement using the 'elephant trunk (ET)' procedure has commonly been applied to acute aortic dissection, but enlargement of a residual false lumen of the descending thoracic aorta sometimes occurs. We performed endovascular stent-grafting to close the entry as the second operation and obtained successful outcomes. From April 1997 to January 2004, we performed the modified ET procedure for acute aortic dissection in 29 patients and evaluated postoperative changes of the false lumen. In many cases of the residual false lumen, kinks and wrinkles were observed at the site of the ET grafts in the descending aorta. An adequate length of ET would be about 8 cm long to prevent kinking, and a diameter about 20 mm to prevent wrinkles.
authors.affiliation: Department of Vascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Nobusato
authors.initials: N
authors.lastname: Koizumi
authors.forename: Y
authors.initials: Y
authors.lastname: Obitsu
authors.forename: M
authors.initials: M
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Iwahashi
authors.forename: S
authors.initials: S
authors.lastname: Makimura
authors.forename: Y
authors.initials: Y
authors.lastname: Yokoi
authors.forename: S
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: H
authors.initials: H
authors.lastname: Shigematsu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D005557:Formaldehyde / Q000008:administration & dosage; D005780:Gelatin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D012118:Resorcinols / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D011093:Polyethylene Terephthalates; D012118:Resorcinols; C027813:gelatin-resorcinol-formaldehyde tissue adhesive; D005557:Formaldehyde; D005780:Gelatin