Early period results for repair of complex thoracic aortic diseases with E-vita open stent graft

Abstract

Aim: Nowadays, usage of hybrid techniques in complex aortic diseases, especially in the high risk patient group for conventional surgery, enables us to cope with the challenges posed in major surgery and reduce complications. In this study, we evaluate our early results in patients who underwent Frozen Elephant Trunk procedure using e-Vita Open stent grafts for complex aortic disease.Methodology: A total of 61 patients (mean age 56 ±11.5, 50 patients (81.9%) were male) who underwent E-vita Open Plus repair between January 2013 and October 201, with the diagnosis of either acute / chronic type I aortic dissection, acute / chronic type III aortic dissection, or thoracic aortic aneurysm were analyzed retrospectively. 21 patients (34.4%) had acute / chronic type I aortic dissection, 22 (36.0%) had acute / chronic type III aortic dissection, 11 (18.0%) had thoracic aortic aneurysm and 7 (11.4%) had residual type I aortic dissection.Results: Arterial cannulation sites were right subclavian artery in 57 patients (93.4%), brachiocephalic artery in 2 patients (3.2%) and ascending aorta in 2 patients (3.2%). The mean times for antegrade cerebral perfusion and cardiopulmonary bypass were 80 minutes (range 52-167) and 178 minutes (range 105-350) respectively. First 30-day mortality rate was 7 (11.4%). In terms of neurological deficit, 2 patients (3.2%) had paraplegia, 3 (4.9%) had major stroke/coma and one (1.6%) had right hemiplegia. Patients with paraplegia and hemiplegia recovered completely and were free of any neurological deficits during discharge. Conclusion:Frozen elephant trunk procedure is a good alternative method which makes the techniques of surgical repair more feasible in the treatment of complex aortic diseases and enables us to use the combination of surgery and endovascular techniques to reduce complications.Key words: Aortic dissection, complex repair, frozen elephant trunk, early results Abstract

Early and mid-term results of frozen elephant trunk procedure for acute type A aortic dissection

“…Because no dissection was detected in arcus components in isletshape arcus aorta replacement cases, arcus aorta was repaired by resecting only the small curvature of arcus aorta and protecting the unity of descending aorta and islet including the components of aortic arch as we described previously. [9]…”

Minimally Frozen Elephant Trunk

“…In complex aortic diseases, frozen elephant trunk procedure can be implemented more easily with acceptable mortality [1][2]. In the last two decades, with increasing experience in minimal invasive surgery and hybrid methods, easier therapy modalities improving the comfort of the patients has been increasingly utilized.…”

“…Complex thoracic aorta diseases can be treated successfully with acceptable mortality and morbidity by means of hybrid surgical techniques [1]. Especially because of its reliability in aortic root surgery, minimum post-operative complications and the short healing process, minimal invasive surgical methods [2], having higher popularity in recent two decades, would improve the success level of hybrid stent graft technology and provide us with better surgical results. In this paper, we described how we treated a patient diagnosed with Type-I aortic dissection successfully by applying Bentall de Bono, arcus aorta restoration, and frozen elephant trunk procedures through mini j sternotomy.…”