Aortic Arch Replacement With Branched Dacron Graft And Antegrade Stent-Graft Deployment

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By Fabrizio Settepani, MD, Vittorio Pedicini, MD, Giuseppe Raffa, MD, Antioco Cappai, MD, Pier Giorgio Malvindi, MD, and Giuseppe Tarelli, MD

This video shows a “home-made” frozen elephant trunk technique for the treatment of a complex aortic disease involving the arch and the proximal descending aorta. A hybrid procedure was planned.

During moderate hypothermia circulatory arrest the aortic arch was replaced with a branched Dacron graft utilizing the elephant trunk technique. After weaning from CPB, a thoracic stent-graft was deployed antegrade through a branch of the Dacron graft. The elephant trunk was utilized as the proximal neck.

This technique allows treatment of complex aortic disease in a single step, reducing the circulatory arrest time when compared to conventional frozen elephant trunk technique.