Staged repair of extensive aortic aneurysms: long-term experience with the elephant trunk technique

Annals of Surgery
Hazim J SafiRoy Sheinbaum

Abstract

This paper reports our experience of a large series of elephant trunk patients accumulated over 12 years. Extensive aneurysms of the ascending/arch and descending thoracic or thoracoabdominal aorta are significant surgical problems that have potential for great morbidity. We adopted a staged approach known as the elephant trunk procedure in 1991, and we have used it with some modifications since that time. Between February 1991 and December 2003, we performed 1660 operations for ascending/arch or descending thoracic/thoracoabdominal aortic aneurysms. Of these, 321 operations were performed in 218 patients for extensive aneurysms with the elephant trunk technique. We performed 218 ascending/arch repairs and 103 descending thoracic or thoracoabdominal aortic replacements. In 218 ascending/arch repairs, strokes occurred in 3 of 218 (2.7%) patients, with 1 of 187 (0.5%) in the retrograde cerebral perfusion group and 2 of 31 (6.5%) in the no-retrograde cerebral perfusion group (odds ratio 0.08, P < 0.009). Thirty-day mortality for this group was 19 of 218 (8.7%). Among 199 recovering patients after stage 1 repair, 4 of 199 (2%) died during the 30-day to 6-week interval between stages. After stage 2 repair, 0 of 103 patients experien...Continue Reading

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Citations

Aug 25, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Timothy A ReschKenneth Ouriel
Feb 27, 2021·Journal of Cardiac Surgery·Ayman SaeyeldinJohn A Elefteriades
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