Arch translocation and the intra-arch elephant-trunk technique with collared graft for extended chronic dissecting aortic aneurysm.
Management of extensive, chronic, dissecting aortic aneurysms after prior repair of the ascending aorta presents a technical challenge for surgeons. A symptomatic 64-year-old patient was admitted for elective surgical repair of an aortic annular dilatation, causing severe aortic regurgitation, and a Crawford type II extended thoracoabdominal aneurysm, 4 years after he underwent primary repair of an acute aortic dissection. The aorta was diffusely dilated, and there were no sites beyond the distal aortic arch where anastomosis could be performed. We successfully performed total aortic replacement with a 2-stage strategy, using an arch translocation technique and an intra-arch elephant-trunk technique.
Department of Surgery and Clinical Science, Yamagchi University School of Medicine, Minami-Kogushi1-1-1, Ube, Yamaguchi 755-8505, Japan.
Shigeru
S
Ikenaga
Akihito
A
Mikamo
Tomoaki
T
Kudo
Hiroshi
H
Kurazumi
Ryo
R
Suzuki
Kimikazu
K
Hamano
D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058017:Vascular Grafting / Q000379:methods*