David Spielvogel, MD, James C

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Presentation transcript:

Aortic Arch Replacement Using a Trifurcated Graft: Simple, Versatile, and Safe David Spielvogel, MD, James C. Halstead, MA (Cantab), MRCS, Matthias Meier, MD, Isaac Kadir, Steven L. Lansman, MD, PhD, Rohit Shahani, MD, Randall B. Griepp, MD The Annals of Thoracic Surgery Volume 80, Issue 1, Pages 90-95 (July 2005) DOI: 10.1016/j.athoracsur.2005.02.002 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Aortic arch resection using trifurcation graft reconstruction of the brachiocephalic vessels. (A) A typical aneurysm; (B) Division of the brachiocephalic vessels and aneurysm mobilization under HCA; (C) SCP via the trifurcated graft utilizing right axillary perfusion, and (D) the completed repair. (HCA = hypothermic circulatory arrest; SCP = selective cerebral perfusion.) The Annals of Thoracic Surgery 2005 80, 90-95DOI: (10.1016/j.athoracsur.2005.02.002) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Four alternatives for placement of the elephant trunk anastomosis using the trifurcated graft technique: (A) distal to the left subclavian artery [57 patients]; (B) between subclavian and left common carotid arteries [28 patients]; (C) between left common carotid and innominate arteries [6 patients]; and (D) proximal to all arch vessels [13 patients]. Proximal placement may be of benefit when no appropriate distal neck exists because of extensive arch dilatation, or the recurrent laryngeal nerve cannot clearly be visualized. The Annals of Thoracic Surgery 2005 80, 90-95DOI: (10.1016/j.athoracsur.2005.02.002) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions