A modified “elephant trunk” procedure was successfully carried out in a 60-year-old female requiring double-barrel distal aortic anastomosis for chronic type-A aortic dissection. Initial rough fixation of the inserted graft to the descending aortic wall was followed by anastomosis of the graft to the descending aorta-to-arch graft with side-branches. Then aortic arch replacement was carried out with individual reconstruction of the three arch vessels.
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SvenssonLG. Rational and technique for replacement of the ascending aorta, arch, and distal aorta using a modified elephant trunk procedure. J Cardiac Surg1992;7: 301–12.
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UedaYMikiSKusuharaKOkitaYTahataTYamanakaK. Surgical treatment of aneurysm or dissection involving the ascending aorta and aortic arch, utilizing circulatory arrest and retrograde cerebral perfusion. J Cardiovasc Surg1990;31: 553–8.
