title: Beveled reversed elephant trunk procedure for complex aortic aneurysm.
abstract: The reversed elephant trunk procedure uses an inverted graft for distal aortic replacement before aortic arch replacement in patients with mega aorta, to reduce the risk in the second stage. However, the conventional technique restricts the maximum diameter of the inverted graft to the aortic graft diameter. We employed a beveled reversed elephant trunk procedure to overcome the discrepancy between graft diameters in a 54-year-old woman with a severely twisted ascending aortic graft and enlarging chronic dissection of the aortic arch and descending thoracic aorta. The patient was discharged with a satisfactory repair and no neurologic deficit.
authors.affiliation: Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan fujikawa.takuya@gmail.com.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fujikawa
authors.affiliation: Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sekine
authors.affiliation: Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Oshima
authors.affiliation: Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
authors.forename: Reo
authors.initials: R
authors.lastname: Kasai
authors.affiliation: Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Sasaguri
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aneurysm; anastomosis; aortic aneurysm; aortic diseases; blood vessel prosthesis implantation; dissecting; surgical; thoracic; vascular surgical procedures