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Ann Thorac Surg 2009;88:e69-e71. doi:10.1016/j.athoracsur.2009.09.024
© 2009 The Society of Thoracic Surgeons
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Chul-Hyun Park
Yang-Bin Jeon
Jae-Ik Lee
Sung-Youl Hyun
Kook-Yang Park
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How To Do It

Staged Repair of a Chronic Dissecting Aneurysm With the Two Elephant Trunks Technique

Chul-Hyun Park, MD*, Chang-Hu Choi, MD, Yang-Bin Jeon, MD, Jae-Ik Lee, MD, Sung-Youl Hyun, MD, Kook-Yang Park, MD

Department of Thoracic and Cardiovascular Surgery, Gil Hospital, Gachon University of Medicine and Science, Incheon, Republic of Korea

Accepted for publication September 10, 2009.

* Address correspondence to Dr Park, Department of Thoracic and Cardiovascular Surgery, Gil Hospital, Gachon University of Medicine and Science, 1198, Kuwol-Dong, Namdong-Ku, Incheon, 405-760, Republic of Korea (Email: cdgpch{at}gilhospital.com).

The elephant trunk technique is a novel staged procedure for the treatment of an extensive thoracic aortic aneurysm. Occasionally, entrapment or obstruction in the smaller lumen occurs with the use of the elephant trunk technique in aortic dissection. The general procedure is to excise a generous portion of the dissecting septum distally for a chronic dissecting aneurysm of the descending thoracic aorta. We present the "two elephant trunks" technique. In this procedure, a single side-branched graft is placed in the descending aorta without excising the dissecting septum during a first-stage operation. This modification is simple to perform and has the possibility to prevent interval rupture for a chronic dissecting aneurysm.






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