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Modified "Elephant Trunk" Procedure for Type-A Aortic Dissection

Department of Cardiovascular Surgery Tenri Hospital Nara, Japan

For reprint information contact: Hitoshi Ogino, MD Tel: 81 7436 35611 Fax: 81 7436 25576 Department of Cardiovascular Surgery, Tenri Hospital, 200 Mishima-cho, Tenri City, Nara 632-8552, Japan.

A modified "elephant trunk" procedure was successfully carried out in a 60-year-old female requiring double-barrel distal aortic anastomosis for chronic type-A aortic dissection. Initial rough fixation of the inserted graft to the descending aortic wall was followed by anastomosis of the graft to the descending aorta-to-arch graft with side-branches. Then aortic arch replacement was carried out with individual reconstruction of the three arch vessels.