Early- and mid-term aortic remodelling after the frozen elephant trunk technique for retrograde type A acute aortic dissection using the new Japanese J Graft open stent graft

Yamane, Yasuo; Uchida, Naoshige; Mochizuki, Seibu; Furukawa, Toshiyuki; Yamada, Kazunori

doi:10.1093/icvts/ivx144

Cited by 41 publications

(32 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The frozen elephant trunk (FET) technique is a promising surgical approach to promote false lumen obliteration without increasing operative risk [7–12]. It is an important option in the treatment that allows for single-stage repair of complex aortic conditions, such as malperfusion, and provides a landing zone for possible stent graft procedures [10, 13].…”

Section: Introductionmentioning

confidence: 99%

“…We started the use of JOSG for only the AAD patients undergoing TAR at our department since 2015 and not for the atherosclerotic thoracic aortic aneurysm patients, owing to the associated paraplegia risk [8, 9]. The FET technique has shown promotion of aortic remodeling by maintaining the true lumen flow and facilitating its expansion and by promoting false lumen thrombosis [7–10, 12, 14, 15]. However, few studies have compared the effectiveness of TAR with and without the FET technique, in terms of the downstream aortic remodeling.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Aortic remodeling with frozen elephant trunk technique for Stanford type A aortic dissection using Japanese J-graft open stent graft

et al. 2018

View full text Add to dashboard Cite

The frozen elephant trunk (FET) technique allows single-stage extended surgical repair of Stanford type A aortic dissection and has shown promotion of aortic remodeling by maintaining the true lumen flow and facilitating its expansion and by promoting false lumen thrombosis. However, few studies have compared the effectiveness of FET technique, in terms of the downstream aortic remodeling. Between 2005 and 2017, 50 patients underwent total arch replacement for Stanford type A aortic dissection, including that with (n = 22) and without FET technique (n = 28). We compared distal aortic remodeling in patients who underwent total arch replacement with (using a J-Graft open stent graft) or without the technique. The false lumen complete thrombosis rate and the ratio of true lumen area at three levels of the descending aorta were evaluated post operation. In FET group, the diameter and length of the stent graft were 29.0 ± 3.9 mm and 70.9 ± 17.4 mm, respectively. The in-hospital death with and without the FET technique was 0 and 3, respectively, with no late death in both groups. Eight patients (28.6%) only in the non-FET group required additional surgical treatment for downstream aorta. In the FET group, the ratio of true lumen area at the level of bronchial carina and false lumen complete thrombosis rate at the levels of bronchial carina and aortic valve were significantly higher than non-FET group. A more favorable remodeling in the descending aorta was observed in patients who underwent FET associated with a total arch replacement compared to those who underwent total arch replacement alone.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aortic remodeling with frozen elephant trunk technique for Stanford type A aortic dissection using Japanese J-graft open stent graft

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In acute type A dissection, an open SG is widely used and shows excellent midterm results in view of good distal aortic remodeling 2, 7, 8. In acute type B dissection, especially symptomatic or complicated dissection, early favorable results have been reported 3, 9, 10.…”

Section: Discussionmentioning

confidence: 99%

Equations for Estimating the Predissected Diameter of the Descending Aorta From Computed Tomographic Images at the Onset of Aortic Dissection

Yamauchi

Masai

Takano

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundEstimation of the predissected descending aortic diameter is important for deciding on the size of a stent graft in cases of acute aortic dissection. However, no equations for estimating this diameter have been previously reported.Methods and ResultsWe developed and validated new equations by investigating computed tomography images that were scanned within 3 years before dissection and those that were scanned immediately after the onset of dissection. Among 1127 patients with acute aortic dissection (425 type A and 702 type B), 36 were matched for the study from October 2005 to March 2017 at 4 centers. New equations were developed in 17 patients and validated in 19 patients. We measured the predissected whole circumference length (CL) and postdissected whole CL, true lumen CL, the major diameter, and the minor diameter of the acutely dissected aorta, followed by calculation of (post‐trueCL+post‐wholeCL)/2 and (post–major diameter+post—minor diameter)/2. Six equations (linear function) and modified equations were derived from each of the above‐mentioned parameters. In the derivation sets, equations that used the parameter of (post‐trueCL+post‐wholeCL)/2 were strongly correlated with pre‐wholeCL (Y=0.9433x+5.0147; R 2=0.9001) and showed significantly less bias compared with the other 5 equations (P<0.0001). In validation sets using this equation, the mean bias of the circumference length and diameter was 2.7±2.8 and 0.85±0.89 mm, respectively. A total of 99.2% of the calculated values were within 3 mm in diameter or less.ConclusionsOur newly developed equations can be used to calculate the predissected aortic diameter in cases of acute aortic dissection and might help to decide the size of the stent graft.

show abstract

“…Our FET technique was described in a previous report. 1 ) The patient’s pericardial cavity was found to be filled with blood. Total cardiopulmonary bypass (CPB) was thus initiated, and the patient’s hemodynamics was stabilized.…”

Section: Case Reportmentioning

confidence: 99%

Hybrid Repair for Ruptured Thoracic Aortic Aneurysm: Frozen Elephant Trunk Technique with Thoracic Endovascular Aortic Repair

Yamane

Hiraoka

Mochizuki

et al. 2018

Annals of Vascular Diseases

Self Cite

View full text Add to dashboard Cite

We present a case of ruptured thoracic aortic aneurysm (TAA) with type B aortic dissection in which hybrid repair, namely, the frozen elephant trunk (FET) technique with thoracic endovascular aortic repair (TEVAR), was performed. The TAA extended to the proximal descending aorta at the level of the pulmonary trunk bifurcation. We thus employed the FET technique to control the blood flow into the TAA. After performing the FET technique, intraoperative catheter aortography revealed slight type 1B endoleak. We therefore performed additional TEVAR to control the blood flow into the TAA. The patient’s postoperative course was uneventful.

show abstract

Early- and mid-term aortic remodelling after the frozen elephant trunk technique for retrograde type A acute aortic dissection using the new Japanese J Graft open stent graft

Cited by 41 publications

References 18 publications

Aortic remodeling with frozen elephant trunk technique for Stanford type A aortic dissection using Japanese J-graft open stent graft

Aortic remodeling with frozen elephant trunk technique for Stanford type A aortic dissection using Japanese J-graft open stent graft

Equations for Estimating the Predissected Diameter of the Descending Aorta From Computed Tomographic Images at the Onset of Aortic Dissection

Hybrid Repair for Ruptured Thoracic Aortic Aneurysm: Frozen Elephant Trunk Technique with Thoracic Endovascular Aortic Repair

Contact Info

Product

Resources

About