Frozen Elephant Trunk Technique to Treat Extensive Thoracic Aortic Mural Thrombus

2021 ◽  
Author(s):  
Dmitri S. Panfilov ◽  
Boris N. Kozlov
Keyword(s):  
Computed Tomography ◽  
Anticoagulation Therapy ◽  
Early Postoperative Period ◽  
Mural Thrombus ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Left Hand ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

AbstractWe describe a case report of a 63-year-old man who presented with chronic left-hand weakness and the absence of a pulse in the left arm. Thoracoabdominal computed tomography (CT) revealed an extensive thoracic aortic mural thrombus. Initial anticoagulation therapy did not provide a positive result, so the patient was referred for surgery. Hybrid aortic arch surgery using the frozen elephant trunk technique was performed with excellent early outcomes. A CT performed in the early postoperative period showed that the thrombus was completely excluded from the aortic lumen by the hybrid graft. No thrombus dislodgment was detected. No thrombus recurrence was observed during 19 months of follow-up.

Complete closure of coronary fistula communicating with the descending aorta

2020 ◽  
pp. 021849232098150
Author(s):  
Monika Kosiorowska ◽  
Lukas Lehmkuhl ◽  
Paul P Urbanski
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Frozen Elephant Trunk ◽  
Coronary Fistula ◽  
Elephant Trunk ◽  
Operative Strategy ◽  
Descending Aorta ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique ◽  
Aortic Pathologies

We report a rare case of complex coronary fistula that contained two aneurysms and was connected to the descending aorta. The fistula was also associated with further aortic pathologies necessitating surgery. Preoperative computed tomography angiography, which revealed an abnormal vessel communication, was crucial for choosing the appropriate operative strategy. During a one-stage procedure comprising closure of both arterial (aortic and coronary) fistula origins and repair of the aortic valve and thoracic aorta, the coronary origin of the fistula was ligated and the frozen elephant trunk technique was used to close the aortic origin.

scholarly journals The surgical management of retrograde type A aortic dissection after thoracic endovascular aortic repair

2020 ◽  
Vol 30 (5) ◽  
pp. 732-738 ◽  
Author(s):  
Yaojun Dun ◽  
Yi Shi ◽  
Hongwei Guo ◽  
Yanxiang Liu ◽  
Bowen Zhang ◽  
...  
Keyword(s):  
Total Arch Replacement ◽  
Long Term Results ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Elephant Trunk Technique ◽  
The Mean ◽  
Frozen Elephant Trunk Technique

Abstract OBJECTIVES Our goal was to review the surgical treatment of retrograde type A aortic dissection (RTAD) after thoracic endovascular aortic repair (TEVAR) in our centre. METHODS From January 2014 to April 2018, 22 patients with RTAD after TEVAR were operated on in our centre. The mean age at operation was 52.0 ± 8.0 years old. The median interval between the primary TEVAR procedure and RTAD was 4.6 months (range 0–120 months). The postoperative mortality and morbidity rates were calculated to evaluate the early and long-term results. RESULTS Twenty patients received total arch replacement with the frozen elephant trunk technique and 2 patients received total arch replacement alone. The mean cardiopulmonary bypass time, aortic cross-clamp time and selective cerebral perfusion time were 172.4 ± 39.3, 100.1 ± 30.3 and 19.7 ± 10.5 min, respectively. The incidence of major adverse events was 18.6% (4/22), including stroke in 1 patient, myocardial dysfunction in 1 patient and renal failure necessitating dialysis in 3 patients. Death within 30 days was 13.6% (3/22 patients). The follow-up data were available for all 19 survivors. The mean follow-up period was 32.2 ± 16.2 months (range 10–62 months). No deaths or aortic-related events occurred during the follow-up period. CONCLUSIONS Total arch replacement with or without the frozen elephant trunk technique was suitable for the management of RTAD after TEVAR, with acceptable early and long-term results.

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