Frozen elephant trunk in acute aortic dissection: a literature review

Murana, Giacomo; Campanini, Francesco; Orioli, Valentina; Pagano, Vinvenzo; Santamaria, Valeria; Di Marco, Luca; Di Bartolomeo, Roberto; Pacini, Davide

doi:10.1007/s12055-023-01624-2

Cited by 1 publication

(2 citation statements)

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“…showing even inferior survival rates with total arch repair and similar reoperation rates in follow-up compared to proximal arch surgery (9). Concentrating FET surgery in acute type A dissection repair to only experienced aortic centers might be a reasonable consequence (21,22). Kaplan-Meier estimates for distal reintervention comparing FET group (red) vs. proximal group (blue) up to 10 years, without significant differences between groups, log-rank test p = 0.17.…”

Section: Resultsmentioning

confidence: 98%

“…Stroke rates were favorably low in our FET patients (2.8%), despite significantly longer circulatory arrest times than proximal arch repairs, which may be attributable to a strict cerebral perfusion protocol, whereas 7% of our conventional proximal group did not receive selective brain perfusion. Contemporary data report stroke rates of 2.7%-18% (21).…”

Section: Resultsmentioning

confidence: 99%

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Frozen elephant trunk versus conventional proximal repair of acute aortic dissection type I

Göbel,

Holder,

Hüther

et al. 2024

Front. Cardiovasc. Med.

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ObjectiveThe extent of surgery and the role of the frozen elephant trunk (FET) for surgical repair of acute aortic dissection type I are still subjects of debate. The aim of the study is to evaluate the short- and long-term results of acute surgical repair of aortic dissection type I using the FET compared to standard proximal aortic repair.MethodsBetween October 2009 and December 2016, 172 patients underwent emergent surgery for acute type I aortic dissection at our center. Of these, n = 72 received a FET procedure, while the other 100 patients received a conventional proximal aortic repair. Results were compared between the two surgery groups. The primary endpoints included 30-day rates of mortality and neurologic deficit and follow-up rates of mortality and aortic-related reintervention.ResultsDemographic data were comparable between the groups, except for a higher proportion of men in the FET group (76.4% vs. 60.0%, p = 0.03). The median age was 62 years [IQR (20), p = 0.17], and the median log EuroSCORE was 38.6% [IQR (31.4), p = 0.21]. The mean follow-up time was 68.3 ± 33.8 months. Neither early (FET group 15.3% vs. proximal group 23.0%, p = 0.25) nor late (FET group 26.2% vs. proximal group 23.0%, p = 0.69) mortality showed significant differences between the groups. There were fewer strokes in the FET patients (FET group 2.8% vs. proximal group 11.0%, p = 0.04), and the rates of spinal cord injury were similar between the groups (FET group 4.2% vs. proximal group 2.0%, p = 0.41). Aortic-related reintervention rates did not differ between the groups (FET group 12.1% vs. proximal group 9.8%, p = 0.77).ConclusionEmergent FET repair for acute aortic dissection type I is safe and feasible when performed by experienced surgeons. The benefits of the FET procedure in the long term remain unclear. Prolonged follow-up data are needed.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%