A novel modification of elephant trunk technique using a single four-branched arch graft for extensive thoracic aortic aneurysm

Surgical repair for the extensive thoracic aortic aneurysm remains unsatisf actory, especially in elderly patients. We developed a total arch replaceme nt with modified elephant trunk technique under moderately hypothermic card iopulmonary bypass and selective brain perfusion, in which a 4-branched arc h graft with a sewing 'collar' enabled the distal anastomosis just proximal to the innominate artery with open distal method and a long 'elephant trun k' was inserted into the descending aorta by the forceps catheter via the f emoral artery. This modification is easy and less invasive, and reduces the risk of postoperative complications. (C) 2000 Elsevier Science B.V. All ri ghts reserved.