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Surgical treatment for chronic dissecting aneurysm (DeBakey Type I) —A case using “elephant trunk” and “aortic tailoring”—

  • Taira Yamamoto
  • Haruo Makuuchi
  • Yoshihiro Naruse
  • Toshiya Kobayashi
  • Masahiro Goto
  • Kenji Nonaka
Case Report
  • 21 Downloads

Abstract

We present a surgical case of a 54-year-old man with chronic dissecting aortic aneurysm (Type I). At the first operation, ascending aorta and aortic arch were replaced with a tube graft under cardiopulmonary bypass and selective cerebral perfusion. Elephant trunk method was employed for the second operation. At the second operation, graft replacement of the proximal two-thirds of the descending aorta was performed, and the lower third of the descending aorta was tailored. Aortic tailoring consisted of the longitudial aortomy and the removal of the intimai flap from the distal part of the descending aorta from the level of the 9th intercostal artery down to the diaphragm. The aorta was closed creating single channel 21 mm in diameter and containing the origins of the important intercostal arteries. He discharged the hospital without any complication including paraplegia or visceral ischemia, and his follow-up CT scan (1 year-later) did not show any dilatation of the tailored segment of the descending aorta and abdominal aorta.

Keywords

Aortic Aneurysm Intercostal Artery Intimal Flap Elephant Trunk Selective Cerebral Perfusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 1998

Authors and Affiliations

  • Taira Yamamoto
    • 1
  • Haruo Makuuchi
    • 1
  • Yoshihiro Naruse
    • 1
  • Toshiya Kobayashi
    • 1
  • Masahiro Goto
    • 1
  • Kenji Nonaka
    • 1
  1. 1.Department of Cardiovascular SurgeryToranomon HospitalTokyoJapan

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