[OUTCOMES OF SURGICAL TREATMENT OF COMPLEX PATHOLOGY OF THE ASCENDING AORTA, AORTIC ARCH, DESCENDING THORACIC AORTA, THROUGH THE "ELEPHANT TRUNK" HYBRID METHOD].

Complete prosthetic surgery of the ascending aorta, aortic arch branches, and descending aorta in patients with aortic arch aneurysm, study and demonstration the possibility of the "elephant trunk" method. The paper describes the technology and demonstrates the results of the first 29 operations of ascending aorta, aortic arch, aortic arch branches and descending thoracic aortic prostheses performed by the staff of the Department of Aortic Pathologies of the Amusov State Institute during 2016-2020. All patients, underwent elephant trunk prosthesis surgery of the ascending aorta, aortic arch, aortic arch branches, and descending thoracic aorta as the first stage of reconstruction of aortic arch pathology. Most of the patients, except for three, underwent the second stage of surgery, endoprosthesis of the aortic arch and descending thoracic aorta through a vascular stent. In case of an aortic arch aneurysm or disruption of the anatomical integrity of blood vessels, restoration of the anatomical integrity of the aortic arch and aortic arch blood vessels or prosthesis of blood vessels in this basin can be performed through "elephant trunk" surgery. Optimization and improvement of preoperative diagnostics, surgical techniques, methods of protection of the brain, spinal cord and visceral organs, the use of hybrid / endovascular techniques allows treatment in case of complex damage to the ascending arch and descending thoracic aorta. The first completely satisfactory results of the performed operations were obtained, the hospital lethality was demonstrated within 10.3%.