Reversed Elephant Trunk Technique for the Repair of Type B Aortic Dissection: A Case Report

• Main Authors: Anjith Prakash Rajakumar, Mithun Sundararaaja Ravikumar, Karthik Raman, Arun Singh, Ejaz Ahmed Sheriff, Rajan Sethuratnam
• Format: Article
• Language: English
• Published: Tehran University of Medical Sciences 2019-03-01
• Series: Journal of Tehran University Heart Center
• Subjects: Dissection; Aortic aneurysm; thoracic; Thrombosis
• Online Access: https://jthc.tums.ac.ir/index.php/jthc/article/view/868
• ISSN: 1735-8620; 2008-2371

We report a case of a type B aortic dissection with an aneurysm treated by the replacement of the proximal descending thoracic aorta via the reversed elephant trunk technique. A 48-year-old asymptomatic man was diagnosed with a type B aortic dissection, moderate aortic regurgitation, and a good biventricular function in March 2012. Four years later (April 2016), a contrast-enhanced computed tomography examination revealed an aneurysmal dilatation in the patient’s descending thoracic aorta with a thrombosis in the proximal part of the false lumen, which warranted surgical repair. He underwent type B aortic dissection repair through the left posterolateral thoracotomy. Three months after the surgery, the patient developed a type A aortic dissection with severe aortic regurgitation, which was successfully managed via a Bentall procedure with arch replacement facilitated by the reversed elephant trunk technique performed during the initial surgery through thoracotomy. At 2 years follow-up, the patient was doing well with a normal left ventricular function.