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Ann Thorac Surg 2007;84:659-661
© 2007 The Society of Thoracic Surgeons

Case Reports

Successful Total Arch Replacement With Long Elephant Trunk for Chronic Aortic Dissection (DeBakey IIIb)

Yasuhiro Shudo, MDa, Kazuhiro Taniguchi, MD, PhDa,*, Hajime Matsue, MD, PhDb, Toshiki Takahashi, MD, PhDb, Koichi Toda, MD, PhDa, Hiroki Hata, MD, PhDa, Yoshiki Sawa, MD, PhDb

a Department of Cardiovascular Surgery, Japan Labour Health and Welfare Organization, Osaka Rosai Hospital, Osaka, Japan
b Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

Accepted for publication December 11, 2006.

* Address correspondence to Dr Taniguchi, 1179-3 Nagasone, Sakai, Osaka 591-8025, Japan (Email: yasuhiro-shudo{at}s5.dion.ne.jp).

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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