J Chest Surg.  2024 Jan;57(1):99-102. 10.5090/jcs.23.084.

Debranch-First Technique with Zone 0 Elephant Trunk for Redo Operation of Residual Type B Aortic Dissection: The Completion of Aortic Proximalization

• Inoue Y

• KMID: 2550636
• DOI: http://doi.org/10.5090/jcs.23.084

Abstract

This article presents a straightforward hybrid arch technique for treating residual type B aortic dissecting aneurysms following type A repair (replacement of the ascending aorta) that employs a frozen elephant trunk (FET) straight vascular prosthesis. The debranch-first method involves only cutting and sewing the previous ascending graft, inserting the FET from zone 0, and debranching the arch vessels using a trifurcated graft. This technique is less invasive as it eliminates the need to manipulate the dissected distal arch aneurysm. We successfully applied this technique to 3 patients, with no instances of in-hospital death, stroke, or paraplegia. The debranch-first technique, combined with zone-0 FET insertion, simplifies the redo repair of residual type B aortic dissection.

Keyword

Type B aortic dissection; Debranch; Frozen elephant trunk; Reoperation; Aortic proximalization