Frozen elephant trunk: the gold standard

Bashir, Mohamad; Idhrees, Mohammed; Al-Tawil, Mohammed; Jubouri, Matti; Agbobu, Tiffany; Chen, Edward P.

doi:10.21037/cdt-23-144

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…The mortality rate is approximately 50% within 48 h of onset and 70% within one month. Surgery is the preferred treatment method, and classic total arch replacement and FET techniques are currently the standard surgical methods ( 10 , 11 ). However, owing to the complexity of the procedure, longer surgical and CPB times are required because of numerous suture operations.…”

Section: Discussionmentioning

confidence: 99%

Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery

Gao,

Yan,

Duan

et al. 2024

Front. Cardiovasc. Med.

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BackgroundAcute Stanford type A aortic dissection (STAAD) is a fatal condition requiring urgent surgical intervention. Owing to the complexity of the surgical process, various complications, such as neurological disorders, are common. In this study, we prioritized the reconstruction of aortic arch branches during surgery and investigated the association between prioritizing the branches and the postoperative outcomes of patients with STAAD.MethodsNinety-seven patients were included in the observational study and underwent total arch replacement and frozen elephant trunk technique between January 2018 and June 2021. Of these, 35 patients underwent the branch-priority technique, and 62 patients underwent the classic technique. By analyzing the perioperative outcomes, we compared the differences between the two techniques.ResultsThe branch priority group had significantly shorter cardiopulmonary bypass and ventilator times and earlier postoperative wake-up times than the classic group. Additionally, the ICU stay time was shorter, with a significant decrease in neurological complications and 24 h drainage in the branch priority group compared to the classic group.ConclusionThe branch priority technique can effectively provide better brain protection, resulting in earlier awakening of patients after surgery, reduced neurological complications, shorter ventilation time and decreased ICU hospitalization time. Therefore, it is recommended for use in aortic dissection surgeries.

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Section: Discussionmentioning

confidence: 99%

Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery

Gao,

Yan,

Duan

et al. 2024

Front. Cardiovasc. Med.

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Non-A Non-B Acute Aortic Dissection: Is There Some Confusion in the Radiologist’s Mind?

Valente,

Sica,

Romano

et al. 2023

Tomography

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Background: The aim of this study is to define and determine the rate of acute non-A–non-B aortic dissections, and to evaluate CT angiography findings and possible complications, as well as to discuss management strategies and currently available therapy. Non-A non-B type of aortic dissection is still a grey area in the radiologist’s mind, such that it is not entirely clear what should be reported and completed in terms of this disease. Methods: A retrospective single-center study including 36 pre-treatment CT angiograms of consecutive patients (mean age: 61 years) between January 2012 and December 2022 with aortic dissection involving the aortic arch with/without the thoracic descending/abdominal aorta (type non-A non-B). Results: According to the dissection anatomy, we identified three modalities of spontaneous acute non-A–non-B anatomical configurations. Configuration 1 (n = 25) with descending-entry tear and retrograde arch extension (DTA entry). Configuration 2 (n = 4) with Arch entry tear and isolated arch involvement (Arch alone). Configuration 3 (n = 7) with Arch entry and anterograde descending (±abdominal) aorta involvement (Arch entry). CT angiogram findings, management, and treatment options are described. Conclusions: Acute non-A non-B dissection represents an infrequent occurrence of aortic arch dissection (with or without involvement of the descending aorta) that does not extend to the ascending aorta. The complete understanding of its natural progression, distinct CT angiography subtypes, optimal management, and treatment strategies remains incomplete. Within our series, patients frequently exhibit a complex clinical course, often necessitating a more assertive approach to treatment compared to type B dissections.

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Frozen elephant trunk: the gold standard

Cited by 2 publications

References 26 publications

Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery

Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery

Non-A Non-B Acute Aortic Dissection: Is There Some Confusion in the Radiologist’s Mind?

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