Heart, Lung and Circulation
How-To-Do-It| Volume 27, ISSUE 6, P767-770, June 2018

Aortic Cannulation in DeBakey Type I Aortic Dissection Facilitates Subsequent Deployment of a Frozen Elephant Trunk

Published:September 15, 2017DOI:
      Arterial cannulation in acute DeBakey type I dissection can be difficult. Moreover, the residual dissected aorta is susceptible to further adverse events in the future. Implanting a stent-graft into the descending aorta during the initial dissection repair (‘frozen elephant trunk’) has been demonstrated to promote favourable aortic remodelling, mitigating some of these longer-term complications. We describe a technique for cannulation of the ascending aorta in acute dissection that facilitates expeditious antegrade deployment of a frozen elephant trunk.


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        • Parikh N.
        • Trimarchi S.
        • Gleason T.G.
        • Kamman A.V.
        • di Eusanio M.
        • Myrmel T.
        • et al.
        Changes in operative strategy for patients enrolled in the International Registry of Acute Aortic Dissection interventional cohort program.
        J Thorac Cardiovasc Surg. 2017; 153: S74-S79
        • Rahimi-Barfeh A.
        • Grothusen C.
        • Haneya A.
        • Schöttler J.
        • Eide A.M.
        • Erdmann M.
        • et al.
        Transatrial cannulation of the left ventricle for acute type A aortic dissection: a 5-year experience.
        Ann Thorac Surg. 2016; 101: 1753-1758
        • Brinster D.R.
        • Parrish D.W.
        • Meyers K.S.
        • Reddy P.
        • Kasirajan V.
        Central aortic cannulation for Stanford type A aortic dissection with the use of three-dimensional and two-dimensional transesophageal echocardiography.
        J Card Surg. 2014; 29: 729-732
        • Pape L.A.
        • Awais M.
        • Woznicki E.M.
        • Suzuki T.
        • Trimarchi S.
        • Evangelista A.
        • et al.
        Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the International Registry of Acute Aortic Dissection.
        J Am Coll Cardiol. 2015; 66: 350-358
        • Pochettino A.
        • Brinkman W.T.
        • Moeller P.
        • Szeto W.Y.
        • Moser W.
        • Cornelius K.
        • et al.
        Antegrade thoracic stent grafting during repair of acute DeBakey type I dissection prevents development of thoracoabdominal aneurysms.
        Ann Thorac Surg. 2009; 88: 482-490
        • Vallabhajosyula P.
        • Szeto W.Y.
        • Pulsipher A.
        • Desai N.
        • Menon R.
        • Moeller P.
        • et al.
        Antegrade thoracic stent grafting during repair of acute DeBakey type I dissection promotes distal aortic remodeling and reduces late open distal reoperation rate.
        J Thorac Cardiovasc Surg. 2014; 147: 942-950
        • Di Bartolomeo R.
        • Pantaleo A.
        • Berretta P.
        • Murana G.
        • Castrovinci S.
        • Cefarelli M.
        • et al.
        Frozen elephant trunk surgery in acute aortic dissection.
        J Thorac Cardiovasc Surg. 2015; 149: S105-S109
        • Desai N.D.
        • Pochettino A.
        Distal aortic remodeling using endovascular repair in acute DeBakey type I aortic dissection.
        Semin Thorac Cardiovasc Surg. 2009; 21: 387-392
        • Murzi M.
        • Tiwari K.K.
        • Farneti P.A.
        • Glauber M.
        Might type A acute dissection repair with the addition of a frozen elephant trunk improve long-term survival compared to standard repair?.
        Interact Cardiovasc Thorac Surg. 2010; 11: 98-102