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Frozen Elephant Trunk: a technique which can be offered in complex pathology to fix the whole aorta in one setting.

Kokotsakis J, Anagnostakou V, Kratimenos T, Ashrafian H, Athanasiou T - J Cardiothorac Surg (2011)

Bottom Line: We report a case of treating complex aortic pathology with the use of the Frozen Elephant Trunk technique in a patient with chronic type B aortic dissecting aneurysm associated with arch and ascending aorta dilatation, proximal aortic disease and coronary disease.The case was further complicated due to the involvement of the abdominal vessels and preexisting femoral to femoral crossover bypass.In addition the patient had a tracheostomy for laryngeal cancer.We emphasize the role of the Frozen Elephant Trunk to fix the whole aorta in one setting with special attention given to the changes taking place in vascular perfusion following correction and reconstitution of the true lumen.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cardiac Surgery Department, Evangelismos General Hospital, Athens, Greece.

ABSTRACT
We report a case of treating complex aortic pathology with the use of the Frozen Elephant Trunk technique in a patient with chronic type B aortic dissecting aneurysm associated with arch and ascending aorta dilatation, proximal aortic disease and coronary disease. The case was further complicated due to the involvement of the abdominal vessels and preexisting femoral to femoral crossover bypass. In addition the patient had a tracheostomy for laryngeal cancer.We emphasize the role of the Frozen Elephant Trunk to fix the whole aorta in one setting with special attention given to the changes taking place in vascular perfusion following correction and reconstitution of the true lumen.

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Postoperative images of the aorta . (a.) 3D CT reconstruction image of the thoracic aorta showing complete replacement of ascending aorta and aortic arch, the FET in the descending thoracic aorta and the saphenous vein grafts originating from the ascending aorta. (b.) Axial CT image demonstrating good flow in the celiac trunk.
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Figure 2: Postoperative images of the aorta . (a.) 3D CT reconstruction image of the thoracic aorta showing complete replacement of ascending aorta and aortic arch, the FET in the descending thoracic aorta and the saphenous vein grafts originating from the ascending aorta. (b.) Axial CT image demonstrating good flow in the celiac trunk.

Mentions: The patient stayed in the intensive care unit for 6 days. He was extubated 18 h after the operation and remained haemodynamically stable and neurologically intact. However he experienced deterioration of his renal function and required temporary haemodialysis for three weeks. A CTA scan was performed at 3 months after surgery and revealed complete thrombosis of the aneurysmal false lumen and expansion of the true lumen of the descending thoracic aorta (Figure 2a). The visceral arteries were perfused from the true lumen (Figure 2b and 2c) while flow in the pre-existing femoral-femoral bypass was reversed (left to right).


Frozen Elephant Trunk: a technique which can be offered in complex pathology to fix the whole aorta in one setting.

Kokotsakis J, Anagnostakou V, Kratimenos T, Ashrafian H, Athanasiou T - J Cardiothorac Surg (2011)

Postoperative images of the aorta . (a.) 3D CT reconstruction image of the thoracic aorta showing complete replacement of ascending aorta and aortic arch, the FET in the descending thoracic aorta and the saphenous vein grafts originating from the ascending aorta. (b.) Axial CT image demonstrating good flow in the celiac trunk.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3117693&req=5

Figure 2: Postoperative images of the aorta . (a.) 3D CT reconstruction image of the thoracic aorta showing complete replacement of ascending aorta and aortic arch, the FET in the descending thoracic aorta and the saphenous vein grafts originating from the ascending aorta. (b.) Axial CT image demonstrating good flow in the celiac trunk.
Mentions: The patient stayed in the intensive care unit for 6 days. He was extubated 18 h after the operation and remained haemodynamically stable and neurologically intact. However he experienced deterioration of his renal function and required temporary haemodialysis for three weeks. A CTA scan was performed at 3 months after surgery and revealed complete thrombosis of the aneurysmal false lumen and expansion of the true lumen of the descending thoracic aorta (Figure 2a). The visceral arteries were perfused from the true lumen (Figure 2b and 2c) while flow in the pre-existing femoral-femoral bypass was reversed (left to right).

Bottom Line: We report a case of treating complex aortic pathology with the use of the Frozen Elephant Trunk technique in a patient with chronic type B aortic dissecting aneurysm associated with arch and ascending aorta dilatation, proximal aortic disease and coronary disease.The case was further complicated due to the involvement of the abdominal vessels and preexisting femoral to femoral crossover bypass.In addition the patient had a tracheostomy for laryngeal cancer.We emphasize the role of the Frozen Elephant Trunk to fix the whole aorta in one setting with special attention given to the changes taking place in vascular perfusion following correction and reconstitution of the true lumen.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cardiac Surgery Department, Evangelismos General Hospital, Athens, Greece.

ABSTRACT
We report a case of treating complex aortic pathology with the use of the Frozen Elephant Trunk technique in a patient with chronic type B aortic dissecting aneurysm associated with arch and ascending aorta dilatation, proximal aortic disease and coronary disease. The case was further complicated due to the involvement of the abdominal vessels and preexisting femoral to femoral crossover bypass. In addition the patient had a tracheostomy for laryngeal cancer.We emphasize the role of the Frozen Elephant Trunk to fix the whole aorta in one setting with special attention given to the changes taking place in vascular perfusion following correction and reconstitution of the true lumen.

Show MeSH
Related in: MedlinePlus