Skip to main content
Log in

Devising a technique for distal anastomosis during total arch replacement using the frozen elephant trunk technique: reverse stepwise anastomosis

  • How to Do It
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Frozen elephant technique is an effective procedure used to repair complex thoracic aortic disease involving the aortic arch and the descending aorta, or to treat aortic dissection. However, the technique often requires some creativity to properly place the stent graft and anastomose the graft to the aorta. We recently used the J Graft FROZENIX® (Japan Lifeline Co., Ltd., Tokyo, Japan) in total arch replacement, and devise a technique for distal anastomosis (called “reverse stepwise anastomosis”) that was simple and easy and caused minimal bleeding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Uchida N, Katayama A, Higashiue S, Shiono M, Hata M, Minami K, et al. A new device as an open stent graft for extended aortic repair: a multicentre early experience in Japan. Eur J Cardiothorac Surg. 2016;49:1270–8.

    Article  PubMed  Google Scholar 

  2. Kato M, Ohnishi K, Kaneko M, Ueda T, Kishi D, Mizushima T, et al. New graft-implanting method for thoracic aortic aneurysm or dissection with a stented graft. Circulation. 1996;94:II188-93.

    Article  PubMed  Google Scholar 

  3. Roselli EE, Isabella MA. Frozen elephant trunk procedure. Op Tech Thoracic Cardiovasc Surg. 2013;18:87–100.

    Article  Google Scholar 

  4. Kokotsakis J, Anagnostakou V, Kratimenos T, Ashrafian H, Athanasiou T. Frozen elephant trunk: a technique which can be offered in complex pathology to fix the whole aorta in one setting. J Cardiothoracic Surg. 2011;6:66.

    Article  Google Scholar 

  5. Ogino H. Open repair of distal aortic arch and proximal descending thoracic aortic aneurysm using a stepwise distal anastomosis. Op Tech Thoracic Cardiovasc Surg. 2007;12:162–6.

    Article  Google Scholar 

  6. Ogino H, Ando M, Sasaki H, Minatoya K. Total arch replacement using a stepwise distal anastomosis for arch aneurysms with distal extension. Eur J Cardiothorac Surg. 2006;29:255–7.

    Article  PubMed  Google Scholar 

  7. Oda K, Akimoto H, Hata M, Akasaka J, Yamaya K, Iguchi A, et al. Use of cuffed anastomosis in total aortic arch replacement. Ann Thorac Surg. 2003;76:952–3.

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was received for the publication of this paper.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hidenori Sako.

Ethics declarations

Conflict of interest

The authors have declared that no conflicts of interest exist.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sako, H., Tanaka, H., Morita, M. et al. Devising a technique for distal anastomosis during total arch replacement using the frozen elephant trunk technique: reverse stepwise anastomosis. Gen Thorac Cardiovasc Surg 66, 492–494 (2018). https://doi.org/10.1007/s11748-018-0903-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-018-0903-4

Keywords

Navigation