Background and aim of the study. To report early clinical outcomes of
the frozen elephant trunk technique (FET) for the treatment of complex
aortic diseases after transition from conventional elephant trunk.
Methods. A single-center, retrospective study of patients who underwent
hybrid aortic arch and FET repair for aortic arch and/or proximal
descending aortic aneurysms, acute and chronic Stanford type A aortic
dissection with arch and/or proximal descending involvement, Stanford
type B acute and chronic aortic dissections with retrograde aortic arch
involvement. Results. Between December 2017 and May 2020, 70 consecutive
patients (62.7±10.6 years, 59 male) were treated: 41 (58.6%) for acute
conditions and 29 (41.4%) for chronic. Technical success was 100%.
In-hospital mortality was 14.2% (n=12, 17.1% emergency vs. 10.3%
chronic, P=NS); 2 (2.9%) major strokes; 1 (1.4%) spinal cord injury.
Follow-up was 12.5 months (IQR 3.7—22.3. Overall survival at 3, 6, 12
and 24 months was 90% (95% CI, 83.2—97.3), 85.6% (95% CI,
77.7—94.3), 79.1% (95% CI, 69.9—89.5), 75.6% (95% CI,
65.8—86.9) and 73.5 (95% CI, 63.3—85.3). There were no aortic
re-interventions and no dSINE; 5 patients with residual type B
dissection underwent TEVAR completion. Conclusions. In a real-world
setting, FET demonstrated a rapid learning curve and good clinical
outcomes, even in acute type A aortic dissections. Techniques to perfect
the procedure and to reduce remaining risks, and consensus on
considerations such as standardized cerebral protection need to be
reported.
Outcomes of single physician-modified fenestrated stent grafts for endovascular repair of thoracic aortic lesions involving the distal aortic arch