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Ann Thorac Surg 2004;78:725-726
© 2004 The Society of Thoracic Surgeons

How to do it

Exposure of the proximal descending thoracic aorta in the first stage of the elephant trunk procedure

Pier Paolo Zanetti, MDa*, Paolo Loddo, MDb, Giovanni Ciuffo, MDb, Salvatore Lentini, MDa, Valter Casati, MDa

a Division of Thoracic and Vascular Surgery, Policlinico di Monza, Monza, Italy
b Division of Thoracic and Vascular Surgery, G. Brotzu Hospital, Cagliari, Italy

Accepted for publication September 25, 2003.

* Address reprint requests to Dr Zanetti, Division of Thoracic and Vascular Surgery, Policlinico di Monza, via Amati 111, Monza (20052), Italy
e-mail: pp.zanetti{at}policlinicodimonza.it

My colleagues and I propose a simple and reproducible technique to achieve optimal exposure and mobilization of the distal aortic arch and proximal descending thoracic aorta in the first stage of the elephant trunk procedure. The technique uses division of the ligamentum arteriosum and a series of circumferential pledgeted traction stitches on the segment of aorta selected for the distal anastomosis.






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