title: Frozen elephant trunk repair for descending thoracic aortic dissection in a man with a hostile left pleural cavity.
abstract: The frozen elephant trunk procedure is a hybrid, single-staged alternative to conventional surgery for repairing diffuse pathologic conditions of the thoracic aorta. This approach is particularly advantageous in patients who have pathologic conditions of the left side of the chest, because the descending thoracic aorta can be repaired without entering a hostile pleural cavity. We present the case of a 67-year-old man who had undergone repair of acute type A aortic dissection. He presented with aneurysmal dilation of the descending thoracic aorta secondary to chronic dissection, a large acute dissection of the proximal ascending aorta, and a large paraesophageal hernia that made him a poor candidate for conventional, 2-staged open aortic repair. We describe the hybrid frozen elephant trunk technique that we used to repair the aorta, and its broader advantages.
authors: Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois 60611.
authors: William D T
authors: WD
authors: Kent
authors: Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois 60611.
authors: Adarsh
authors: A
authors: Manjunath
authors: Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois 60611.
authors: S Chris
authors: SC
authors: Malaisrie
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006551:Hernia, Hiatal / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aneurysm, dissecting/surgery; aortic aneurysm, thoracic/complications/surgery; blood vessel prosthesis implantation/methods; risk factors; stents; treatment outcome