Two-Stage Repair With Classic Elephant Trunk and TEVAR for an Extensive Thoracic Aorta Aneurysm

In this video, the authors present the case of a patient with an extensive thoracic aorta aneurysm, who was treated with a two-stage hybrid approach. The patient initially underwent total arch replacement with classic elephant-trunk technique using a 30 mm Vascutek Siena graft. Antegrade selective cerebral perfusion with moderate hypothermia was used for cerebral protection. Three months later, complete endovascular exclusion of the remaining thoracic aorta was performed. Both postoperative courses were uneventful, and the patient remained well at the 6-month follow-up visit, with unchanged aortic appearances and stable aortic diameters.