Successful Total Arch Replacement With Long Elephant Trunk for Chronic Aortic Dissection (DeBakey IIIb) Yasuhiro Shudo, MD, Kazuhiro Taniguchi, MD, PhD,

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Successful Total Arch Replacement With Long Elephant Trunk for Chronic Aortic Dissection (DeBakey IIIb) Yasuhiro Shudo, MD, Kazuhiro Taniguchi, MD, PhD, Hajime Matsue, MD, PhD, Toshiki Takahashi, MD, PhD, Koichi Toda, MD, PhD, Hiroki Hata, MD, PhD, Yoshiki Sawa, MD, PhD The Annals of Thoracic Surgery Volume 84, Issue 2, Pages 659-661 (August 2007) DOI: 10.1016/j.athoracsur.2006.12.013 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative evaluation of chronic aortic dissection (DeBakey IIIb). The primary entry site was found to be the distal aortic arch. The pseudolumen was not thrombosed. The Annals of Thoracic Surgery 2007 84, 659-661DOI: (10.1016/j.athoracsur.2006.12.013) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Preoperative evaluation of chronic aortic dissection (DeBakey IIIb). (A) Blood flow in the superior mesenteric and bilateral renal arteries was from the true lumen. (B) Blood flow in the celiac and inferior mesenteric arteries was from the pseudolumen. The common hepatic artery was supplied from the superior mesenteric artery and the splenic artery from the collateral arteries. The Annals of Thoracic Surgery 2007 84, 659-661DOI: (10.1016/j.athoracsur.2006.12.013) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Postoperative results after total arch replacement with a long elephant trunk. (B) Schematic illustration of the present total arch replacement with long elephant trunk method. The pseudolumen in the descending aorta was effectively thrombo-excluded to the T12 level. Visceral blood flow was preserved. The Annals of Thoracic Surgery 2007 84, 659-661DOI: (10.1016/j.athoracsur.2006.12.013) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions