title: Frozen elephant trunk procedure in a dextropositioned arch and descending aorta.
abstract: OBJECTIVE
  To describe the use of a hybrid frozen elephant trunk technique to treat a patient suffering from a multisegmentally diseased, dextropositioned aortic arch and right descending aorta.
  
  
  METHODS
  The technique is illustrated in a 58-year-old woman who was diagnosed with chronic type A aortic dissection in a right aortic arch and descending aorta; a lusoric left subclavian artery passed behind the esophagus. Aneurysmal dilatation of the arch and descending aorta required treatment. A frozen elephant trunk procedure was performed in a single stage via a median sternotomy using a hybrid Chavan-Haverich endograft, with complete surgical replacement of aortic arch. The stents for the endograft were placed in the descending aorta in an antegrade fashion through the opened aortic arch.
  
  
  CONCLUSIONS
  This case demonstrates the feasibility of treating complex pathologies of the thoracic aorta even in cases of aberrant anatomy. A conventional 2-stage approach for treatment of the complex pathology could have been complicated due to difficulties with exposure.
authors.affiliation: Department of Cardiothoracic Surgery, Klinikum Oldenburg, Oldenburg, Germany. easo.jerry@klinikum-oldenburg.de
authors.forename: Jerry
authors.initials: J
authors.lastname: Easo
authors.forename: Philipp
authors.initials: P
authors.lastname: Hölzl
authors.forename: Valentin
authors.initials: V
authors.lastname: Dikov
authors.forename: Ajay
authors.initials: A
authors.lastname: Chavan
authors.forename: Otto
authors.initials: O
authors.lastname: Dapunt
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000295:instrumentation; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D056346:Sternotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome