Abstract
A 75-year-old man developed persistent dysphagia 2 months after successful total arch replacement with a long elephant trunk (ET) for a distal arch aneurysm. Enhanced computed tomography revealed not only complete thrombosis of the distal arch aneurysm, but also rapid expansion of another downstream aortic aneurysm with esophageal compression. Thoracic endovascular aortic repair was undertaken for this symptomatic aortic aneurysm, which was totally thrombo-excluded. ET might produce turbulent or jet-like blood flow from its tip in some situations and have a potential to accelerate the expansion of the downstream aneurysm. Additional endovascular ET completion is simple, effective, and less invasive.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Safi HJ, Miller CC III, Estrera AL, Huvnh TT, Porat EE, Allen BS, et al. Staged repair of extensive aortic aneurysms: long-term experience with the elephant trunk technique. Ann Surg 2004;240:677–684.
Kuki S, Taniguchi K, Masai T, Yokota T, Yoshida K, Yamamoto K, et al. An alternative approach using long elephant trunk for extensive aortic aneurysm: elephant trunk anastomosis at the base of the innominate artery. Circulation 2002;24(106):I253–I258.
Taniguchi T, Toda K, Hata H, Shudo Y, Matsue H, Takahashi T, et al. Elephant trunk anastomosis proximal to origin of innominate artery in total arch replacement. Ann Thorac Surg 2007;84:1729–1734.
Toda K, Taniguchi K, Masai T, Takahashi T, Kuki S, Sawa Y. Arch aneurysm repair with long elephant trunk: a 10-year experience in 111 patients. Ann Thorac Surg 2009;88(1):16–22.
Brandt M, Hussel K, Walluscheck K, Müller-Hülsbeck S, Jahnke T, Rahimi A, et al. Stent-graft repair versus open surgery for the descending aorta: a case-control study. J Endovasc Ther 2004;11:535–538.
Demers P, Miller DC, Mitchell RS, Kee ST, Sze D, Razavi MK, et al. Midterm results of endovascular repair of descending thoracic aortic aneurysms with first-generation stent grafts. J Thorac Cardiovasc Surg 2004;127:664–673.
Khoynezhad A, Donayre CE, Bui H, Kopchok GE, Walot I, White RA. Risk factors of neurologic deficit after thoracic aortic endografting. Ann Thorac Surg 2007;83:S882–S889.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Higuchi, T., Takahashi, T., Ishizaka, T. et al. Rapid expansion of another downstream aortic aneurysm with the elephant trunk. Gen Thorac Cardiovasc Surg 58, 617–619 (2010). https://doi.org/10.1007/s11748-009-0577-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-009-0577-z