scholarly journals Frozen elephant trunk procedure for complex aortic arch surgery: The Salerno experience with Thoraflex hybrid

2021 ◽  
Author(s):  
Paolo Masiello ◽  
Generoso Mastrogiovanni ◽  
Oreste Presutto ◽  
Pierpaolo Chivasso ◽  
Vito Domenico Bruno ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Surgery ◽  
Elephant Trunk Procedure

scholarly journals Different aortic arch surgery methods for type A aortic dissection: clinical outcomes and follow-up results

2020 ◽  
Vol 31 (2) ◽  
pp. 254-262
Author(s):  
Yunxing Xue ◽  
Jun Pan ◽  
Hailong Cao ◽  
Fudong Fan ◽  
Xuan Luo ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Clinical Outcomes ◽  
Type A ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Aortic Arch Surgery

Abstract OBJECTIVES The aim of this study was to investigate the clinical outcomes and follow-up results among 5 main aortic arch surgery methods for type A aortic dissection in a single centre. METHODS From 2002 to 2018, 958 type A aortic dissection patients who received surgical repair were divided into 5 groups according to the arch surgery method: hemiarch replacement (n = 206), island arch replacement (n = 54), total arch replacement with frozen elephant trunk (n = 425), triple-branched stent (n = 39) and fenestrated stent (n = 234). The indications for the different arch methods were related to the patient’s preoperative status, the location and extent of the dissection and the surgical ability of the surgeons. A comparative study was performed to identify the differences in the perioperative data, and the Kaplan–Meier analysis was used to assess the long-term survival and reintervention rates. Thirty matched surviving patients that were included in each group completed Computed tomography angiography to determine long-term reshaping effect. RESULTS The 30-day mortality rate was 15.8%, and there was no difference among the 5 groups (P = 0.848). The follow-up survival rates were similar among the 5 groups (P = 0.130), and the same was true for patients without reintervention (P = 0.471). In the propensity matching study, patients with stents (frozen elephant trunk, triple-branched stent, fenestrated stent) had a slower aortic dilation rate and a higher ratio of thrombosis in the false lumen at the descending aortic and abdominal aortic levels than patients without stents. CONCLUSIONS No standard method is available for arch surgery, and indications and long-term effects should be identified with clinical data. In our experiences, simpler surgical procedures could reduce mortality in critically ill patients and stents in the distal aorta could improve long-term reshape effects.

Suturing Fenestration of the Left Subclavian Artery Orifice in Frozen Elephant Trunk Procedure

2020 ◽  
Author(s):  
Mitsumasa Hata ◽  
Shinji Wakui ◽  
Yusuke Ishii ◽  
Rei Hinoura ◽  
Susumu Isaka ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Distal Part ◽  
Left Subclavian Artery ◽  
Frozen Elephant Trunk ◽  
Bleeding Events ◽  
Elephant Trunk ◽  
Novel Technique ◽  
Elephant Trunk Procedure

AbstractThe frozen elephant trunk (FET) procedure enables easier replacement of the entire aortic arch because it does not require reaching the distal part of the left subclavian artery (LSCA). However, it requires additional management for reconstruction of the LSCA, which is associated with bleeding events. However, the fenestrated FET technique confers a risk of endoleakage from the fenestration site. We report our unique novel technique in which the proximal side of the hybrid stent graft is cut into V-shape around the subclavian artery and sutured continuously around the orifice of the subclavian artery during aortic stump fixation.

Outcomes of Concomitant Frozen Elephant Trunk (FET) in Aortic Arch Surgery in a Specialised Aortic Centre

2020 ◽  
Vol 4 (sup1) ◽  
pp. 127-128
Author(s):  
Saleem Muhammad Jahangeer ◽  
Shahd Mobarak ◽  
Ijas Moideen ◽  
Akbar Vohra ◽  
Ragheb Hasan ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Surgery

scholarly journals Single-Stage Treatment of Extensive Aortic Pathology Using the Frozen Elephant Trunk Procedure

2020 ◽  
Vol 23 (5) ◽  
pp. E606-E610
Author(s):  
Petar Risteski ◽  
Vasil Papestiev ◽  
Stefanija Hadzievska ◽  
Nadica Mehmedovic ◽  
Nikola Lazovski ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Single Stage ◽  
Frozen Elephant Trunk ◽  
Organ Protection ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Cardiac Morbidity ◽  
Aortic Pathology ◽  
Cord Injury ◽  
Elephant Trunk Procedure

Background: Extensive pathology involving the aortic arch and descending aorta traditionally has been treated with two open procedures. We report our institutional experience with a single stage frozen elephant trunk procedure for treatment of extensive aortic pathology. Methods: Between June 2018 and October 2019, nine patients (eight males, 89%, mean age 61 ± 6 years) with extensive aortic pathology were operated using the frozen elephant trunk procedure. Five (56%) patients underwent primary operation for chronic arch and proximal descending aneurysm in two (22%) patients, chronic type B aortic dissection in two (22%) patients and penetrating aortic ulcer in one (11%) patient. The other four (44%) patients received reoperative surgery for chronic post-dissection aneurysms. For organ protection during the aortic arch procedure, we used selective antegrade cerebral perfusion and mild systemic hypothermia at 28°C. Results: Early mortality was not observed. A single (11%) patient developed focal stroke. Unilateral vocal cord palsy was present in two (22%) patients. Spinal cord injury was not observed. Reexploration for bleeding was required in two (22%) patients. Prolonged ventilation, liver and kidney failure as well as cardiac morbidity were not observed. Two patients (22%) with anticipated Endoleak type Ib received TEVAR extension at follow up. Mid-term mortality was observed in two (22%) patients, due to pneumonia. Conclusion: The frozen elephant trunk procedure can be used for a single-stage treatment of patients with extensive aortic pathology, due to chronic degenerative aneurysms or post-dissection aneurysms involving the aortic arch and the descending aorta, with acceptable mortality and morbidity.

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