Frozen elephant trunk procedure in a dextropositioned arch and descending aorta

J Endovasc Ther. 2010 Dec;17(6):751-4. doi: 10.1583/10-3169.1.

Abstract

Purpose: To describe the use of a hybrid frozen elephant trunk technique to treat a patient suffering from a multisegmentally diseased, dextropositioned aortic arch and right descending aorta.

Technique: The technique is illustrated in a 58-year-old woman who was diagnosed with chronic type A aortic dissection in a right aortic arch and descending aorta; a lusoric left subclavian artery passed behind the esophagus. Aneurysmal dilatation of the arch and descending aorta required treatment. A frozen elephant trunk procedure was performed in a single stage via a median sternotomy using a hybrid Chavan-Haverich endograft, with complete surgical replacement of aortic arch. The stents for the endograft were placed in the descending aorta in an antegrade fashion through the opened aortic arch.

Conclusion: This case demonstrates the feasibility of treating complex pathologies of the thoracic aorta even in cases of aberrant anatomy. A conventional 2-stage approach for treatment of the complex pathology could have been complicated due to difficulties with exposure.

Publication types

  • Case Reports

MeSH terms

  • Aorta, Thoracic / abnormalities
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Chronic Disease
  • Endovascular Procedures* / instrumentation
  • Female
  • Humans
  • Magnetic Resonance Angiography
  • Middle Aged
  • Prosthesis Design
  • Stents
  • Sternotomy
  • Tomography, X-Ray Computed
  • Treatment Outcome