Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Luong D, Knipe H, et al. Elephant trunk repair. Reference article, Radiopaedia.org (Accessed on 13 Dec 2024) https://doi.org/10.53347/rID-53699
An elephant trunk repair is a type of open repair procedure devised to address combined aneurysms, it is often a two staged procedure wherein the arch repair is facilitated by sternotomy and a second staged procedure is performed via left thoracotomy for the descending or thoracoabdominal aorta.
- typical aortic surgery complications
- risk of graft occlusion
- graft kinking
- neurologic dysfunction (stroke, encephalopathy, spinal cord injury)
- mediastinitis
- renal insufficiency
- need for tracheostomy
- hemorrhage
- unique complications related to the configuration of the elephant trunk
- clot formation around the free end of the elephant trunk
- peripheral thromboembolism due to graft flapping
- left recurrent laryngeal nerve paralysis
- vocal cord paralysis
- entrapment of the free end of the graft within the true or false lumen, eliminating flow in the other lumen and perfusion of the abdominal branches that arise from that lumen
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Some publications have suggested high survival rates ranging around 98% for the first operation and 92% for the second 5.
History and etymology
It was devised in 1983 by Hans Borst and colleagues.
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1. Johnson PT, Corl FM, Black JH, Fishman EK. The elephant trunk procedure for aortic aneurysm repair: an illustrated guide to surgical technique with CT correlation. AJR. American journal of roentgenology. 197 (6): W1052-9. doi:10.2214/AJR.11.6349 - Pubmed
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2. Kokotsakis J, Anagnostakou V, Kratimenos T, Ashrafian H, Athanasiou T. Frozen Elephant Trunk: a technique which can be offered in complex pathology to fix the whole aorta in one setting. Journal of cardiothoracic surgery. 6: 66. doi:10.1186/1749-8090-6-66 - Pubmed
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3. Neri E, Toscano T, Frati G, Sassi C. The elephant trunk technique: a new complication. Texas Heart Institute journal. 28 (3): 220-2. Pubmed
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4. Preventza O, Al-Najjar R, Lemaire SA, Weldon S, Coselli JS. Total arch replacement with frozen elephant trunk technique. Annals of cardiothoracic surgery. 2 (5): 649-52. doi:10.3978/j.issn.2225-319X.2013.06.01 - Pubmed
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5. Svensson LG. The elephant trunk procedure: uses in complex aortic diseases. Current opinion in cardiology. 20 (6): 491-5. Pubmed
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6. Svensson LG, Kim KH, Blackstone EH, Alster JM, McCarthy PM, Greenberg RK, Sabik JF, D'Agostino RS, Lytle BW, Cosgrove DM. Elephant trunk procedure: newer indications and uses. The Annals of thoracic surgery. 78 (1): 109-16; discussion 109-16. doi:10.1016/j.athoracsur.2004.02.098 - Pubmed
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