Purpose of review: The elephant trunk procedure is used for extensive aneurysms involving both the ascending aorta/aortic arch and the descending thoracic or thoracoabdominal aorta.
Recent findings: This is a high-risk staged procedure; however, with current techniques in our most recent series the survival rate was 98% for the first operation and 92% for the second.
Summary: With the more liberal use of hybrid procedures and endovascular stenting for the second stage of the elephant trunk procedure, the operation can be used more often in patients with severe comorbid disease, particularly respiratory problems.
Center for Aortic Surgery, Marfan and Connective Tissue Disorder Clinic, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Correspondence to Lars G Svensson, MD, PhD, Director, Center for Aortic Surgery, Marfan and Connective Tissue Disorder Clinic, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation/F24, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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