Work

Successful staged repair of arch and descending thoracic aortic aneurysms with conventional elephant trunk and TEVAR

Year: 2026

Type: article

Abstract: BACKGROUND: Thoracic aortic aneurysms (TAA) involving both the arch and descending aorta present significant surgical challenges. Hybrid approaches combining open repair with thoracic endovascular aortic repair (TEVAR) are increasingly adopted for complex cases. CASE PRESENTATION: We report the case of a 64-year-old male with hypertension, dyslipidemia, and COPD, who presented with dyspnea and cough. Imaging revealed large aneurysms of the aortic arch (8 × 9 cm) and descending thoracic aorta (10 × 9 cm), both layered with thrombus. The patient underwent a staged procedure: (1) total arch replacement with elephant trunk, and (2) TEVAR for the descending thoracic aneurysm. Postoperatively, the patient developed seizures and respiratory complications requiring tracheostomy, but subsequently stabilized. CT angiography confirmed successful graft placement with no endoleak, although a small residual iliac artery aneurysm and venous thrombosis were noted. CONCLUSION: A staged hybrid approach combining elephant trunk and TEVAR provides an effective treatment strategy for extensive thoracic aortic aneurysms, especially in high-risk patients.

Source: Journal of Cardiothoracic Surgery

DOI: 10.1186/s13019-026-04164-z

Authors: Chandra Sekaran Aravind, Sujith Velayudhan Indira, Surya Prakash Sabapathi, Nivetha Deivamathi Ravi, Venkat Naveen Makkina, Thoddi Ramamurthy Muralidharan

Institutions: SRM Institute of Science and Technology, SRM Medical College Hospital and Research Centre

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,890