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J Thorac Cardiovasc Surg 2009;137:777-778
© 2009 The American Association for Thoracic Surgery

Brief Communication

Repair for acute type A aortic dissection with a long elephant trunk technique

Hiroki Hata, MD, PhD, Koichi Toda, MD, PhD, Yasuhiro Shudo, MD, Satoshi Kainuma, MD, Kiyoshi Yoshida, CE, Keiji Yamamoto, CE, Kazuhiro Taniguchi, MD, PhD*

Department of Cardiovascular Surgery and Clinical Engineering Section, Japan Labour Health and Welfare Organization, Osaka Rosai Hospital, Sakai, Japan

Received for publication December 18, 2007; revisions received June 13, 2008; accepted for publication July 6, 2008.

* Address for reprints: Kazuhiro Taniguchi, MD, PhD; 1179-3, Nagasone-cho, Kita-ku, 591-8025 Sakai, Japan. (Email: hatahiro1019@yahoo.co.jp).

The first 20% of the full text of this article appears below.

Total arch replacement (TAR) is often performed for acute type A aortic dissection (AAAD) involving the aortic arch.1Go However, because conventional TAR including the use of a short elephant trunk2,3Go requires careful dissection of the surrounding tissue and elaborate distal anastomosis at the site of dissection and occasionally at the site of the aneurysm, there could be some cases in which bleeding is uncontrollable or circulatory arrest time is prolonged. To reduce such problems, we applied TAR with distal anastomosis just proximal to the innominate artery using a long elephant trunk (LET) technique, which we4,5Go have introduced for true arch aneurysms and chronic aortic dissections.

Clinical Summary

Four consecutive patients with AAAD (3 men) underwent surgical repair, from March 2006 to January 2007, with TAR using the LET technique. The mean age was 62 years (range, 51–71 years). Preoperative computed tomography (CT) and transesophageal echocardiography revealed that in all cases the entry site was located in the ascending aorta near the innominate artery. All cases were DeBakey type I. There were not any dissection-related complications.

TAR using a 4-branched Hemashield arch graft (Hemashield Platinum, Woven Double . . . [Full Text of this Article]




This article has been cited by other articles:


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 Ann. Thorac. Surg.Home page
K. Toda, K. Taniguchi, T. Masai, T. Takahashi, S. Kuki, Y. Sawa, and Osaka Cardiac Surgery Research (OSCAR) Group
Arch Aneurysm Repair With Long Elephant Trunk: A 10-Year Experience in 111 Patients
Ann. Thorac. Surg., July 1, 2009; 88(1): 16 - 22.
[Abstract] [Full Text] [PDF]


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