Minimally Frozen Elephant Trunk

Abstract

Background: While surgery involves high surgical mortality and morbidity in complex thoracic aortic diseases, surgical exposure is very important, and it is necessary to explore the area as wide as possible. Increased experience in minimal invasive surgery and advances in hybrid stent graft technologies allow us to perform easy and successful operations through a limited incision area. A 39year-old male patient applied to our clinic with hoarseness and back pain complaints, and was diagnosed with chronic Type-I aorta dissection. Methods:We described how we treated the patient successfully by applying Bentall de Bono, arcus aorta restoration, and frozen elephant trunk procedures through mini j sternotomy. For better manipulation of the aortic arch branches, after the placement of 24/29Fr Carpentier two-stage bicaval femoral venous cannula from innominate vein through to inferior vena cava, left innominate vein was divided. Results:Patient was discharged at 6th post-operative day without any neurological deficit and hoarseness. No upper extremity swelling or neurological complications were observed due to left innominate vein division. Conclusion:With increasing usage of hybrid methods in aortic surgery, we believe that partial J mini-sternotomy implementations can be carried out successfully and safely in arc us aorta and proximal descending aorta operations, involving even type-1 aortic dissections.