scholarly journals “ELEPHANT TRUNK” AND ENDOVASCULAR STENTGRAFTING – A HYBRID APPROACH TO THE TREATMENT OF EXTENSIVE THORACIC AORTIC ANEURYSM

2013 ◽  
Vol 56 (2) ◽  
pp. 80-82 ◽  
Author(s):  
Tomáš Holubec ◽  
Jan Raupach ◽  
Jan Dominik ◽  
Jan Vojáček
Keyword(s):  
Thoracic Aorta ◽  
Thoracic Aortic Aneurysm ◽  
Hybrid Approach ◽  
Giant Aneurysm ◽  
Aortic Aneurysms ◽  
Elephant Trunk ◽  
Mortality And Morbidity ◽  
Thoracic Aortic Aneurysms ◽  
Ventricular Septum Defect ◽  
Elephant Trunk Technique

A hybrid approach to elephant trunk technique for treatment of thoracic aortic aneurysms combines a conventional surgical and endovascular therapy. Compared to surgery alone, there is a presumption that mortality and morbidity is reduced. We present a case report of a 42-year-old man with a giant aneurysm of the entire thoracic aorta, significant aortic and tricuspid regurgitation and ventricular septum defect. The patient underwent multiple consecutive operations and interventions having, among others, finally replaced the entire thoracic aorta with the use of the hybrid elephant trunk technique.

scholarly journals The frozen elephant trunk technique: A new treatment for thoracic aortic aneurysms

2003 ◽  
Vol 125 (6) ◽  
pp. 1550-1553 ◽  
Author(s):  
Matthias Karck ◽  
Ajay Chavan ◽  
Christian Hagl ◽  
Holger Friedrich ◽  
Michael Galanski ◽  
...  
Keyword(s):  
Aortic Aneurysms ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Thoracic Aortic Aneurysms ◽  
Elephant Trunk Technique ◽  
New Treatment ◽  
Frozen Elephant Trunk Technique

scholarly journals The frozen elephant trunk technique in acute DeBakey type I aortic dissection

2020 ◽  
Vol 28 (3) ◽  
pp. 411-418
Author(s):  
Davut Çekmecelioğlu
Keyword(s):  
Aortic Dissection ◽  
Thoracic Aorta ◽  
Median Sternotomy ◽  
Type I ◽  
Frozen Elephant Trunk ◽  
Descending Thoracic Aorta ◽  
Elephant Trunk ◽  
Mortality And Morbidity ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

Although advances in the field of cardiovascular surgery have improved outcomes for patients with acute DeBakey type I aortic dissection, postoperative in-hospital mortality and morbidity remain substantial. The frozen elephant trunk technique has become a treatment option for this disease and was developed primarily to extend repair into the proximal descending thoracic aorta during aortic arch repair (because the descending thoracic aorta is largely inaccessible via median sternotomy), thus avoiding, delaying, or facilitating subsequent repair of residual native aorta. In this review, we discuss the evidence for and future development of frozen elephant trunk reconstruction for acute DeBakey type I aortic dissection.

The Frozen Elephant Trunk Technique for Treatment of Thoracic Aortic Aneurysms

2007 ◽  
Vol 83 (2) ◽  
pp. S819-S823 ◽  
Author(s):  
Hassina Baraki ◽  
Christian Hagl ◽  
Narwid Khaladj ◽  
Klaus Kallenbach ◽  
Jürgen Weidemann ◽  
...  
Keyword(s):  
Aortic Aneurysms ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Thoracic Aortic Aneurysms ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

scholarly journals Hybrid Approach in Acute and Chronic Aortic Disease

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 49
Author(s):  
Michele Murzi ◽  
Pier Andrea Farneti ◽  
Antonio Rizza ◽  
Silvia Di Sibio ◽  
Cataldo Palmieri ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Circulatory Arrest ◽  
Hybrid Approach ◽  
Aortic Disease ◽  
Aortic Aneurysms ◽  
Single Stage ◽  
Elephant Trunk ◽  
Profound Hypothermia ◽  
Elephant Trunk Technique

The management of patients with aortic disease that involves the ascending aorta, the aortic arch, and the descending aorta represent a surgical challenge. Open surgical repair remains the gold standard for aortic arch pathologies. However, this operation requires a cardiopulmonary bypass and a period of profound hypothermia and circulatory arrest, which carries a substantial rate of mortality and morbidity. For these reasons, hybrid arch repair that involves a combination of open surgery with endovascular aortic stent graft placement has been introduced as a therapeutic alternative for those patients deemed unfit for open surgical procedures. Hybrid repair requires varying degrees of invasiveness and can be performed as a single-stage procedure or as a two-stage procedure. The choice of the technique is multifactorial, depending on the characteristics of the diseased arch with regard to position of the stent graft proximal landing zone, patient fitness and comorbid status, as well as surgical expertise and hospital facilities. Among the evolving hybrid procedures is the so-called “frozen” or stented elephant trunk technique. Adapted from the classical elephant trunk technique, this approach facilitates the repair of a concomitant aortic arch and proximal descending aortic aneurysms in a single stage under circulatory arrest. This technique is increasingly being used to treat extensive thoracic aortic disease and has shown promising results.

scholarly journals Thoraflex hybrid as frozen elephant trunk in chronic, residual type A and chronic type B aortic dissection

2020 ◽  
Author(s):  
Mariafrancesca Fiorentino ◽  
Hector W L de Beaufort ◽  
Uday Sonker ◽  
Robin H Heijmen
Keyword(s):  
Thoracic Aorta ◽  
False Lumen ◽  
Frozen Elephant Trunk ◽  
True Lumen ◽  
Elephant Trunk ◽  
Stroke Incidence ◽  
The Status ◽  
Elephant Trunk Technique ◽  
Complete Thrombosis ◽  
Aortic Dissections

Abstract OBJECTIVES The frozen elephant trunk technique is an increasingly common treatment for extensive disease of the thoracic aorta. The objective of the study was to evaluate the outcomes of frozen elephant trunk specifically in chronic (residual) aortic dissections, focusing on downstream aortic remodelling. METHODS Between 2013 and 2019, a total of 28 patients were treated using the Vascutek Thoraflex hybrid graft at our institution for chronic dissections/post-dissection aneurysms. Immediate and follow-up outcomes were studied, as well as the changes in total aortic diameter, true lumen and false lumen diameter and the status of the false lumen at 3 different levels of the thoraco-abdominal aorta. RESULTS No in-hospital or 30-day mortality was observed, temporary paraparesis rate was 7% and disabling stroke incidence was 14.3%. Freedom from all-cause mortality at 2 years was 91.6 ± 5.7%, while freedom from reintervention on the downstream aorta at 2 years was 59.1 ± 10.8%. Positive aortic remodelling was achieved in 50.0%, with an enlargement in the true lumen and a reduction of the false lumen not only at the level of the proximal descending aorta with 73.1% of complete thrombosis but also at the level of the distal descending thoracic aorta, with 41.7% of complete thrombosis. CONCLUSIONS The frozen elephant trunk is a good solution in chronic (residual) downstream aortic dissections inducing positive aortic remodelling and preventing from II stage operations or allowing an endovascular approach.

Diseases of the Aorta

2018 ◽  
Author(s):  
Anna M Booher ◽  
Kim A Eagle
Keyword(s):  
Aortic Dissection ◽  
Thoracic Aortic Aneurysm ◽  
Clinical Presentation ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Type B ◽  
Thoracic Aortic Aneurysms ◽  
Computed Tomographic ◽  
Abdominal Aortic ◽  
Acute Aortic Syndromes

This review covers the major presentations affecting the aorta: aortic aneurysms (abdominal aortic aneurysms and thoracic aortic aneurysms), acute aortic syndromes (including aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer), other nonacute aortic processes, and traumatic disease of the aorta. The section on abdominal aortic aneurysms covers screening, clinical presentation, diagnostic evaluation, management to reduce the risk of aneurysm rupture, open surgical treatment and endovascular aortic repair, and the role of medical therapy. The section on thoracic aortic aneurysms also covers pathophysiology, etiology, and inherited and inflammatory conditions. Aortic dissections affect either the ascending aorta (type A) or the descending aorta (type B) and may be classified as acute or chronic. The discussion of aortic dissection describes the clinical presentation, diagnostic steps and decisions, and treatment for both type A and type B dissections. The figures include two algorithms: a potential management strategy for patients with thoracic aortic aneurysm and a logical procedure for the evaluation and treatment of a suspected aortic dissection. Figures also include illustrations, computed tomographic images, and echocardiograms of various aortic presentations. Tables list normal aortic dimensions by computed tomographic angiography and echocardiography, etiology and associated factors in diseases of the aorta, revised Ghent criteria for the diagnosis of Marfan syndrome, size criteria for elective surgical intervention in thoracic aortic aneurysm, and independent predictors of in-hospital death. Also included is a follow-up imaging timeline for acute aortic syndromes. This review contains 9 figures, 6 tables, and 132 references.

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