Abstract
The frozen elephant trunk (FET) is an effective method for making the distal anastomosis
more proximal and facilitating aortic remodeling in acute aortic dissection. However,
misdeployment of FET to the false lumen has been reported in several cases. Such cases
are usually treated with bail-out thoracic endovascular aortic repair (TEVAR) through
the femoral artery or additional FET under direct vision to redirect the blood flow
to the true lumen. We encountered a case of misdeployment of FET into the false lumen
during open aortic surgery for the treatment of Stanford type A acute aortic dissection.
After reconstruction of the aorta and all arch vessels, we performed antegrade bail-out
TEVAR through a side branch of the four-arm Dacron graft as main access using a pull-through
technique through the right femoral artery, which was perfused from the true lumen.
This technique, which uses a Dacron graft branch for stent graft access, enabled us
to confirm the true lumen because the distal anastomotic site was definitely the true
lumen, and we were also able to avoid access difficulties at the iliac artery.
Keywords
frozen elephant trunk - bail-out thoracic endovascular aortic repair - side branch
of four-arm dacron graft - pull-through technique
