Repair of stent graft-induced retrograde type A aortic dissection using the E-vita open prosthesis

Gorlitzer, Michael; Weiss, Gabriel; Moidl, Reinhard; Folkmann, Sandra; Waldenberger, Ferdinand; Czerny, Martin; Grabenwöger, Martin

doi:10.1093/ejcts/ezs041

Cited by 36 publications

(34 citation statements)

References 23 publications

(30 reference statements)

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“…Suitable patients should be hemodynamically stable and the ascending aortic FL thrombosed while the ascending aorta is preferably not severely dilated (ie, <5.5 cm). Recently, there has been a plethora of studies on retro-A AD occurring secondarily to thoracic endovascular aortic repair, [8][9][10] but the literature on spontaneous acute retro-A AD, which is a distinct entity, is limited. Previous studies were mostly conducted on small patient cohorts or mentioned through case reports.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Acute Retrograde Type A Aortic Dissection With an Entry Tear in Descending Aorta

et al. 2014

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Background-Optimal management strategy of acute aortic dissection (AD) with retrograde extension from entry tear in the descending aorta into the ascending aorta remains undetermined. Methods and Results-Of the 538 patients who were diagnosed as having acute AD from 1999 through 2011, 49 patients (37 men; 52.5±13.1 years) were identified as having entry tear in the descending aorta with retrograde extension of AD into the ascending aorta. Sixteen patients who were clinically stable with thrombosed false lumen in the ascending aorta were treated medically (MED group), whereas 33 patients underwent aortic replacement (SURG group) on an intentionto-treat basis. In the MED group, 1 patient was converted to urgent aortic surgery and 2 patients underwent endovascular stent grafting in the descending aorta during the initial hospitalization. The early (30-day or in-hospital) mortality rates were 0% and 9.1% in the MED and SURG group, respectively (P=0.54).

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Section: Discussionmentioning

confidence: 99%

Outcomes of Acute Retrograde Type A Aortic Dissection With an Entry Tear in Descending Aorta

et al. 2014

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“…The supraaortic vessels may be anastomosed end-to-end to side branches of the graft or as a patch. [6][7][8][9][10][11][12][13] Unfortunately, some delivery systems are quite cumbersome and deployment of the stented portion of the graft might be imprecise, therefore causing a far more distal landing than intended.…”

Section: Introductionmentioning

confidence: 99%

Long-term results of simplified frozen elephant trunk technique in complicated acute type A aortic dissection: A case–control study

et al. 2016

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Aim: To describe the long-term experience of a simplified frozen elephant trunk technique (sFETT) used in complicated acute type A aortic dissection (AAAD) treatment. Methods and results: Between January 2001 and December 2012, 34 patients (mean age 59.9 AE 11.0 years) with complicated AAAD (DeBakey I) underwent an emergency surgery including sFETT. sFETT consisted in gluing the dissected aortic arch wall layers with gelatine-resorcinol adhesive and video-assisted antegrade open arch aortic stent-graft deployment in the arch or proximal descending aorta. In addition to sFETT, the aortic root was addressed with standard techniques. A 30-day mortality was 14.7% (five patients) due to bleeding (1), multiple organ failure (2), and colon ischemia (2). Postoperative morbidity included neurological (2), renal (1) and cardio-pulmonary complications (4), as well as wound infection (1). Mean follow-up was 74.4 AE 45.0 months. Actual survival rates were 73.5% at 1 year, 70.2% at 5 years, and 58.5% at 13 years of follow-up. Six patients died during long-term follow-up from heart failure (1) and unknown reasons (5). Five patients required reoperation for aortic arch (3) or aorto-iliac (2) progression of aneurysm during the mid-and long-term follow-up. The remaining patients showed favorable evolution of the dissected aorta with false lumen occlusion in most cases and stable aortic diameters. Conclusions: In AAAD patients, sFETT as used in our series is an easy and safe technique to repair the aortic arch. Long-term results after sFETT showed false lumen occlusion and stable aortic diameter in up to 13 years of follow-up.

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“…10) TAR-FET has been reported as a valuable tool for the treatment of the same sites. 11) We mainly performed TAR-FET in patients who were not indicated for TEVAR (i.e., those who were outside the scope of our institutional recommendations and required debranching+TEVAR or those at increased risk for RTAD). There are several reasons supporting early adoption of TAR-FET.…”

Section: Discussion Indicationsmentioning

confidence: 99%

“…Notably, there are certain disadvantages, such as uncertain peripheral landing (iatrogenically occurring peripheral new entry and SINE owing to TEVAR performed for Stanford type B aortic dissection and bending of aortic grafts), the use of cardiopulmonary bypass, circulatory arrest (TAR is needed for cardiopulmonary bypass and circulatory arrest, whereas TEVAR is not), cooling of the entire body, lower body circulatory arrest, and spinal cord disorders associated with spinal cord ischemia. 8,11) Adjustments were made to overcome these drawbacks. First, a longer FET was selected (90-120 mm) and was placed parallel to the descending thoracic aorta to prevent interference with the aortic wall.…”

Section: Methodsmentioning

confidence: 99%

Surgical Strategies for Type B Aortic Dissection by Frozen Elephant Trunk

Matsuzaki

Yamasaki

Hohri

et al. 2019

Annals of Vascular Diseases

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The timing and choice of surgical method for type B aortic dissection, is still a topic of much debate. We performed total arch replacement using frozen elephant trunk (TAR-FET) as a means of preventing distant aortic events, such as retrograde type A aortic dissection (RTAD). We conducted analysis of 142 patients with acute type B dissection who were admitted between January of 2010 and July of 2017. Fifty-five cases required surgical intervention to treat enlargement of the false lumen diameter and ULP formation 2 weeks after the onset of symptoms. 17 TAR-FET were performed with a mean of 42±26 days period from onset to surgery. There were no complications of RTAD or paraplegic, and 90% of patient demonstrated aortic event free survival (5 years) and false lumen reduction ratio of 35%. Based on our analysis, using TAR-FET properly avoids serious complications like RTAD, and is a viable treatment option for type B dissection. (This is a translation of

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Repair of stent graft-induced retrograde type A aortic dissection using the E-vita open prosthesis

Cited by 36 publications

References 23 publications

Outcomes of Acute Retrograde Type A Aortic Dissection With an Entry Tear in Descending Aorta

Outcomes of Acute Retrograde Type A Aortic Dissection With an Entry Tear in Descending Aorta

Long-term results of simplified frozen elephant trunk technique in complicated acute type A aortic dissection: A case–control study

Surgical Strategies for Type B Aortic Dissection by Frozen Elephant Trunk

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