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Editorial
. 2018 May;7(3):437-442.
doi: 10.21037/acs.2018.05.09.

Modified branched reverse frozen elephant trunk repair for failed TEVAR

Shinichi Fukuhara  1 , Eric E Roselli  1
Affiliations
Editorial

Modified branched reverse frozen elephant trunk repair for failed TEVAR

Shinichi Fukuhara et al. Ann Cardiothorac Surg. 2018 May.
No abstract available

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Multi-planar reconstruction of contrast enhanced computed tomography performed after his initial TEVAR repair in the sagittal (A) and axial (B) planes. Green arrow in the sagittal view demonstrates the so-called “bird beak” mal-apposition of the device to the aortic wall in the arch. Green arrow in the axial view demonstrates the dilated proximal arch. TEVAR, thoracic endovascular aortic repair.
Figure 2
Figure 2
Multi-planar reconstruction of contrast enhanced computed tomography performed 2 years after his initial TEVAR repair in the sagittal (A) and axial (B) planes demonstrated the mal-apposed stent in the arch with surrounding endoleak and aneurysmal proximal arch. TEVAR, thoracic endovascular aortic repair.
Figure 3
Figure 3
Illustrations demonstrating some of the steps of performing the reverse frozen elephant trunk repair with modified branching. (A) Demonstrates the burning of the fenestration into the stent graft, followed by branch device delivery with a smaller covered self-expanding covered stent in (B). The device is then deployed with overlap into the aortic lumen in (C). (D) Demonstrates a completed repair with anastomosis in the mid to proximal arch zone 1 or 2 with the stented branch into the left subclavian artery across the frozen elephant trunk, hybrid anastomosis of the left common carotid artery and direct anastomosis to the innominate trunk.
Figure 4
Figure 4
Contrast enhanced multi-planar reconstruction CT scan images of the thoracic aorta post repair. (A) Demonstrates the root replacement with valve reimplantation (arrow) and (B) demonstrates the patent arch branch vessels (arrows).
Video
Video
Modified branched reverse frozen elephant trunk repair for failed TEVAR.
See this image and copyright information in PMC

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References

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