title: Use of the frozen elephant trunk technique in complicated chronic dissection with porcelain aorta and visceral arteries originating from different lumens.
abstract: A rare case of aortic arch aneurysm combined with chronic aortic dissection is reported. Because the visceral arteries originated from different, equivalently perfused lumens and the descending aorta was circumferentially calcified (porcelain aorta) limiting the possibilities of anastomosing, careful planning of the surgical strategy was of utmost importance. The complex surgery consisted of ascending and total arch replacement using the 'frozen elephant trunk' technique with Thoraflex™ Hybrid Prosthesis (Vascutek, Terumo, Inchinnan, Scotland); however, before insertion of the stent graft, an angioscopic resection of the dissection membrane in the proximal part of the descending aorta was carried out to ensure a complete expansion of the distal edge of the stent within the entire common lumen of the aorta and unimpaired distal flow in both lumens below the stent graft. The surgery and the postoperative course were uneventful.
authors.affiliation: Department of Cardiac Surgery, Silesian Center for Heart Diseases, Zabrze, Poland.
authors.forename: Michal O
authors.initials: MO
authors.lastname: Zembala
authors.affiliation: Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany.
authors.forename: Vadim
authors.initials: V
authors.lastname: Irimie
authors.affiliation: Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany p.urbanski@kardiochirurg.de.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Urbanski
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; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000150:complications* / Q000000981:diagnostic imaging; D014781:Viscera / Q000098:blood supply*
keywords: Aortic arch surgery; Chronic aortic dissection; Endovascular aortic repair; Porcelain aorta