Skip to main content
. 2012 Mar;44(1):P42–P47.

Figure 1.

Figure 1

A completed total aortic arch replacement by the traditional elephant trunk approach. At the distal anastomosis, the tubular aortic graft has been sewn directly to the aneurysmal descending thoracic aorta. The brachiocephalic branches have been reattached by using the island technique. The “trunk” of graft is left suspended in the descending thoracic aorta to be used during the subsequent second-stage repair of the remaining distal aneurysm. Reproduced with permission from Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Mathews JB, Pollock RE, eds. Schwartz’s Principles of Surgery, 9th ed. New York: McGraw-Hill; 2010; Chap. 22, Figure 22-6A.