Elephant trunk prosthesis was devised for treatment of multiple aortic aneurysm. But it has applied to type A aortic dissection. Because residual false lumen often dilates gradually and come to have the risk of rupture. Two patients who were diagnosed as type A aortic dissection were performed total aortic arch replacement with Elephant trunk prosthesis on distal anastmosis. Postoperative diagnostic images showed that residual false lumen of proximal descending aorta were thrombosed. Now it is not necessary to perform next extensive aortic replacement. Complication which is threatened in using Elephant trunk prosthesis, paraplegia, thromboembolism, kinking of prosthesis could have been avoided by setting suitable length and diameter of the prosthesis.
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