Frozen elephant trunk in a bovine arch as a complex REDO-surgery: tips and tricks

Pseudoaneurysm of the ascending aorta and arch is a rare complication after cardiovascular surgery, and its natural progression remains poorly understood. The clinical polymorphism of this pathology necessitates the use of repetitive imaging to establish an early diagnosis and to program an elective corrective surgery during which, the proximal the proximal and distal vascular control is always challenging. In this paper, we illustrate how a complex redo extended replacement of proximal aorta with a frozen elephant trunk can be achieved in a simple step-by-step procedure based on the case-report of a 69-year-old patient. The patient had received 12 years earlier a Flow Weave Plus vascular prosthesis in a supra-coronary position under normothermic extracorporeal circulation to treat an ascending aortic aneurysm and was indicated for a redo surgery due to dehiscence of the distal anastomosis and progression of an aortic arch aneurysm.