Surgical outcome of elephant-trunk anastomosis between the left carotid and subclavian arteries in aortic arch repair including the postoperative physical status of the left arm.

We studied the outcome of our modified aortic arch replacement procedure in which the distal end of the graft is anastomosed between the left common carotid artery and the left subclavian artery including the postoperative physical status of the left arm in comparison with the conventional technique. We assessed the surgical outcome of 26 patients who underwent our new technique and 11 patients who underwent the conventional one. Postoperative clinical symptoms and physical status of the left arm were also evaluated. No operative deaths were observed in the new technique group and one operative death was observed in the conventional group (9.1%). No significant differences between the two groups in postoperative clinical symptoms and the physical status of the left arm were observed. Our "distal anastomosis to the proximal level of the left subclavian artery" technique made aortic arch replacement easier and steadier with a satisfactory surgical outcome in comparison with the conventional method. The postoperative clinical symptoms and physical status of the left arm in the new technique group were identical to those in the conventional group.