Successful total arch replacement with long elephant trunk for chronic aortic dissection (DeBakey IIIb).

Shudo, Yasuhiro; Taniguchi, Kazuhiro; Matsue, Hajime; Takahashi, Toshiki; Toda, Koichi; Hata, Hiroki; Sawa, Yoshiki · Ann Thorac Surg · 2007

case_report · Level V

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Abstract

A 68-year-old man presenting with abdominal distention was found on enhanced computed tomography to have a dilated ascending aorta and aortic dissection (DeBakey IIIb). Through a median sternotomy, we performed a total arch replacement using a four-branched Hemashield graft (Meadox Medical, Oakland, NJ) and a long elephant trunk anastomosis at the base of the innominate artery. Postoperatively, a pseudolumen of the descending aorta was effectively thrombo-excluded to the T12 level. Visceral blood flow was preserved, and the patient's postoperative course was uneventful.

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