THE ELEPHANT TRUNK PROCEDURE was first described in 1983 by Borst et al to facilitate
repair of complex aortic aneurysms.
1
Several modifications of the procedure have been developed, but the principle of
a graft that can be unfolded distally and used as a proximal anastomosis site or endovascular
stent landing site in a second descending aortic aneurysm repair has persisted.
2
,
3
,
4
Intraoperative transesophageal echocardiography (TEE) has become an important adjunct
in aortic repairs.
5
,
6
The use of TEE guidance and monitoring in the second-stage stent grafting of an elephant
trunk has been reported before.
7
,
8
Intraoperative TEE may also be important in identifying problems with folding and
kinking of these grafts during initial placement and deployment. The authors describe
2 cases in which TEE identified improper unfolding of an elephant trunk during initial
placement in ascending aortic and aortic arch repair and elephant trunk kinking during
stent-graft placement.Key words
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Article info
Publication history
Published online: January 26, 2007
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© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
