• Peter H Lin, Alan Dardik, and Joseph S Coselli.
• Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Michael E. DeBakey VA Medical Center, Houstan, Texas 77030, USA. plin@bcm.edu
• J. Endovasc. Ther. 2007 Oct 1;14(5):669-71.

PurposeTo describe a technique to facilitate antegrade thoracic endograft deployment using a hybrid elephant trunk operation under hypothermic circulatory arrest.TechniqueWhen using a nitinol-based endograft in a hybrid endovascular aortic arch repair performed in a hypothermic patient, the endograft does not expand fully when the body temperature is typically maintained below 20 degrees C. Immersing the nitinol-based thoracic endograft in a sterile hot saline bath (48 degrees C) for 1 to 2 minutes prior to deployment warms the stent-graft to a physiological temperature of 38 degrees C, which it maintains for several minutes while being deployed.ConclusionAlthough the described technique represents an off-label approach to the use of a TAG device, we believe warming a nitinol-based endograft may potentially improve the technical success of this hybrid operation when the patient is under hypothermic circulatory arrest.

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