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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

PubMed Disclaimer

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

References

    1. Roselli EE, Rafael A, Soltesz EG, et al. Simplified frozen elephant trunk repair for acute DeBakey type I dissection. J Thorac Cardiovasc Surg 2013;145:S197-201. 10.1016/j.jtcvs.2012.11.068 - DOI - PubMed
    1. Roselli EE, Tong MZ, Bakaeen FG. Frozen elephant trunk for DeBakey type 1 dissection: the Cleveland Clinic technique. Ann Cardiothorac Surg 2016;5:251-5. 10.21037/acs.2016.05.03 - DOI - PMC - PubMed
    1. Roselli EE, Idrees JJ, Bakaeen FG, et al. Evolution of Simplified Frozen Elephant Trunk Repair for Acute DeBakey Type I Dissection: Midterm Outcomes. Ann Thorac Surg 2018;105:749-55. 10.1016/j.athoracsur.2017.08.037 - DOI - PubMed
    1. Roselli EE, Subramanian S, Sun Z, et al. Endovascular versus open elephant trunk completion for extensive aortic disease. J Thorac Cardiovasc Surg 2013;146:1408-16; discussion 1416-7. 10.1016/j.jtcvs.2013.07.070 - DOI - PubMed
    1. Shrestha M, Bachet J, Bavaria J, et al. Current status and recommendations for use of the frozen elephant trunk technique: a position paper by the Vascular Domain of EACTS. Eur J Cardiothorac Surg 2015;47:759-69. 10.1093/ejcts/ezv085 - DOI - PubMed

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