| The Elephant Trunk Procedure
for Aortic Dissection |
(Department of Cardiovascular Surgery, National
Cardiovascular Center, Osaka, Japan, Department of Surgery II,
Tokyo Medical University*, Tokyo, Japan and Department of Thoracic
Surgery, Fujita Health University School of Medicine**, Toyoake,
Japan)
| Nobusato Koizumi* |
Motomi Ando** |
Yuji Hanafusa |
| Osamu Tagusari |
Hitoshi Ogino |
Soichiro Kitamura |
|
The elephant trunk procedure is
used to close the false lumen of the distal aorta in the surgical
treatment for aortic dissection. We examined the state of the
false lumen thrombus and measured the diameter of the aortic
dissection, using postoperative digital subtraction angiography
and computed tomographic scanning. We performed the elephant
trunk procedure in 24 cases in the period, between January 1995
to December 1999. Total aortic arch replacement was performed
in Stanford type A dissection, and descending aorta replacement
was performed in Stanford type B dissection. In all patients,
thrombotic closure around the elephant trunk graft was confirmed.
Thromboexclusion of the false lumen of the descending aorta was
observed in 18 cases (75.0%). The secondary operation may be
unnecessary, because there was a tendency towards reduction of
the diameter of dissecting aorta. These data revealed that this
procedure was effective. In 6 cases (25.0%), residual dissection
was recognized in the thoracoabdominal aorta, but there was no
case of expansion requiring further operation. Nevertheless,
careful follow-up is necessary, because aneurysms could expand
in the future.
Jpn. J. Cardiovasc. Surg. 32: 267 -271 (2003) |
|
