2002
DOI: 10.1016/s1010-7940(01)01088-0
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The elephant trunk technique: operative results in 100 consecutive patients

Abstract: The first step in the repair of a mega aorta, the implantation of an ET, can be performed with a low mortality and an acceptable morbidity. The risk of central neurologic damage is higher in emergency interventions.

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Cited by 128 publications
(99 citation statements)
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“…1,3,9,10 Mortality rates of 5.1% for the first-stage operation, 3.6% during the interval period (of which 75% were due to rupture), and 6.2% for the second-stage operation were reported by Safi and colleagues 3 and recently updated 1 and confirmed by others. 12 In our own series of 142 elephant trunks, the first-stage operative mortality rate was 2%, and of those patients who underwent the distal repair, a 4% mortality rate was noted. 9 Endovascular therapy avoids a left lateral thoracotomy.…”
Section: Discussionmentioning
confidence: 74%
“…1,3,9,10 Mortality rates of 5.1% for the first-stage operation, 3.6% during the interval period (of which 75% were due to rupture), and 6.2% for the second-stage operation were reported by Safi and colleagues 3 and recently updated 1 and confirmed by others. 12 In our own series of 142 elephant trunks, the first-stage operative mortality rate was 2%, and of those patients who underwent the distal repair, a 4% mortality rate was noted. 9 Endovascular therapy avoids a left lateral thoracotomy.…”
Section: Discussionmentioning
confidence: 74%
“…Table 1 shows the most up-to-date conventional ET case series reports. Even if the cumulative in-hospital mortality and neurological complications including first and second stages are reported, the results are excellent [8,10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25]. As confidence grew and technical adjuncts, such as cerebral protection with retrograde and eventually selective antegrade cerebral perfusion during arrest [26] and various supraaortic vessels reconstruction techniques, were introduced, ET indications were further extended.…”
Section: Conventional Et Techniquementioning
confidence: 99%
“…As confidence grew and technical adjuncts, such as cerebral protection with retrograde and eventually selective antegrade cerebral perfusion during arrest [26] and various supraaortic vessels reconstruction techniques, were introduced, ET indications were further extended. For example, in patients scheduled for descending or thoraco-abdominal aortic surgery, who presented at the same time with a severe coronary artery or valvular disease requiring operation, an ET was placed in the descending aorta to facilitate subsequent aortic repair and similarly, so to speak prophylactically, in selected patients undergoing aortic arch replacement with a downstream aneurysm not requiring immediate surgery at the time, but whose diameter and growth pattern, along with patient risk factors and characteristics (e.g., Marfan syndrome and connective tissue disorders, blood hypertension, and young patients) would suggest an unfavorable development toward further dilation and earlier need for operation [13,14,[20][21][22]25]. Evidence for false-lumen obliteration and healing following the use of the ET technique in patients with acute aortic dissection further encouraged its use [10,[14][15][16][17][18][19][20][21]24].…”
Section: Conventional Et Techniquementioning
confidence: 99%
“…They have generally reported excellent results even when both first and second stage operations were included (37)(38)(39).…”
Section: The "Elephant Trunk" Techniquementioning
confidence: 99%