Outcomes of Concomitant Frozen Elephant Trunk (FET) in Aortic Arch Surgery in a Specialised Aortic Centre

2020 ◽  
Vol 4 (sup1) ◽  
pp. 127-128
Author(s):  
Saleem Muhammad Jahangeer ◽  
Shahd Mobarak ◽  
Ijas Moideen ◽  
Akbar Vohra ◽  
Ragheb Hasan ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Surgery

scholarly journals Different aortic arch surgery methods for type A aortic dissection: clinical outcomes and follow-up results

2020 ◽  
Vol 31 (2) ◽  
pp. 254-262
Author(s):  
Yunxing Xue ◽  
Jun Pan ◽  
Hailong Cao ◽  
Fudong Fan ◽  
Xuan Luo ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Clinical Outcomes ◽  
Type A ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Aortic Arch Surgery

Abstract OBJECTIVES The aim of this study was to investigate the clinical outcomes and follow-up results among 5 main aortic arch surgery methods for type A aortic dissection in a single centre. METHODS From 2002 to 2018, 958 type A aortic dissection patients who received surgical repair were divided into 5 groups according to the arch surgery method: hemiarch replacement (n = 206), island arch replacement (n = 54), total arch replacement with frozen elephant trunk (n = 425), triple-branched stent (n = 39) and fenestrated stent (n = 234). The indications for the different arch methods were related to the patient’s preoperative status, the location and extent of the dissection and the surgical ability of the surgeons. A comparative study was performed to identify the differences in the perioperative data, and the Kaplan–Meier analysis was used to assess the long-term survival and reintervention rates. Thirty matched surviving patients that were included in each group completed Computed tomography angiography to determine long-term reshaping effect. RESULTS The 30-day mortality rate was 15.8%, and there was no difference among the 5 groups (P = 0.848). The follow-up survival rates were similar among the 5 groups (P = 0.130), and the same was true for patients without reintervention (P = 0.471). In the propensity matching study, patients with stents (frozen elephant trunk, triple-branched stent, fenestrated stent) had a slower aortic dilation rate and a higher ratio of thrombosis in the false lumen at the descending aortic and abdominal aortic levels than patients without stents. CONCLUSIONS No standard method is available for arch surgery, and indications and long-term effects should be identified with clinical data. In our experiences, simpler surgical procedures could reduce mortality in critically ill patients and stents in the distal aorta could improve long-term reshape effects.

A simplified delivery frozen elephant trunk technique to reduce circulatory arrest time in hybrid aortic arch surgery

2021 ◽  
Author(s):  
Thomas Sénage ◽  
Nicolas Bonnet ◽  
Guillaume Guimbretière ◽  
Charles‐Henri David ◽  
Jean‐Christian Roussel ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Surgery ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

scholarly journals Preliminary results of single centre experience with the “release and perfuse technique” during aortic arch surgery.

2022 ◽  
Author(s):  
Antonio Piperata ◽  
Nicolas d’Ostrevy ◽  
Olivier Busuttil ◽  
Thomas Modine ◽  
Giulia Lorenzoni ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Fresh Frozen Plasma ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Post Intervention ◽  
Aortic Arch Surgery ◽  
Packed Red Blood Cells ◽  
Primary Endpoints ◽  
Fresh Frozen

Background and aim of the study To evaluate whether the release and perfuse technique implies a circulatory arrest time comparable with or shorter than those of standard Frozen Elephant Trunk technique in aortic arch surgery. Methods We retrospectively reviewed the records of patients who had undergone aortic arch repair with Release and Perfuse Technique (RPT) or standard Frozen Elephant Trunk (FET) at our Institution between January 2018 and May 2021. Primary endpoints were the comparison of circulatory arrest time, perioperative variables, and complications between two groups. A propensity score weighting approach was used for data analysis. Results A total of 41 patients underwent aortic arch surgery were analyzed:15 (37%) and 26 (63 %) in RPT and FET group, respectively. The use of RPT showed a significant shorter circulatory arrest times than FET: 9 min vs 58 min (P < 0.001), respectively. The median lactates peak in the first 24h post intervention was 2.6 for RPT group and 5.4 mmol/L for FET group, (P <0.0001). When compared with the FET, RPT is associated with significant reduction in the use of packed red blood cells (P <0.0001), fresh frozen plasma (P <0.0001), platelet concentrate (P <0.0001), and fibrinogen (P <0.004). The median ICU stay was 3 and 9 days (P = 0.011), whereas the median hospital stay was 12 and 18.5 days (P=0.004) in the RPT and FET groups, respectively. Thirty-day mortality and postoperative outcomes were comparable between the two groups. Conclusions Considering the anatomical limitations related to the use of this technique, the RPT appears to be safe, feasible, and effective in reducing the circulatory arrest time during aortic arch surgery. Nevertheless, further studies are required to demonstrate its safety and efficacy.

scholarly journals Profound bilateral deafness complicating aortic arch surgery

2020 ◽  
Author(s):  
Fabienne Carré ◽  
Elisabeth Mamelle ◽  
Suzanne Ferrier ◽  
Paul Achouh
Keyword(s):  
Hearing Loss ◽  
Cardiac Surgery ◽  
Aortic Arch ◽  
Rare Complication ◽  
Sudden Deafness ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Surgery ◽  
Profound Deafness ◽  
Bilateral Deafness

Abstract Hearing loss is a rare complication of cardiac surgery; bilateral profound deafness has never been reported in this setting. A 45-year-old male presented with profound bilateral sudden deafness following arch surgery and frozen elephant trunk. Patient’s presentation, surgery details and aetiological mechanisms are discussed.

scholarly journals Correlation of coagulopathy and frozen elephant trunk use in aortic arch surgery: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Mohamad Bashir ◽  
Hadi Abo Aljadayel ◽  
Mostafa Mousavizadeh ◽  
Mahdi Daliri ◽  
Yousef Rezaei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aortic Arch ◽  
Meta Analysis ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Surgery

scholarly journals Correlation of Coagulopathy and Frozen Elephant Trunk Use in Aortic Arch Surgery: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Mohamad Bashir ◽  
Hadi Abo Aljadayel ◽  
Mostafa Mousavizadeh ◽  
Mahdi Daliri ◽  
Yousef Rezaei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aortic Arch ◽  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Fresh Frozen Plasma ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Surgery ◽  
Stent Type ◽  
Fresh Frozen

Background: The advent of Frozen elephant trunk (FET) for reconstruction of elective and non-elective aortic arch surgery has augmented the treatment of complex aortic pathologies in a single-stage operation. To date, no studies have been focused on the prevalence and predictors of coagulopathy potentiated by FET procedure. Methods: In a systematic review, we searched databases up to June 2020 for studies reporting coagulopathy complications after FET procedure. A proportional meta-analysis was carried out using STATA software (StataCorp, TX, USA). Results: In total, 46 studies including 6313 patients were eligible. The pooled estimation of reoperation for postoperative bleeding was 7% (95% confidence interval [CI] 5 to 8; I2 = 84.73%; reported by 39 studies including 4796 patients). The mean volume of transfused packed blood cells and fresh frozen plasma was 1677 ml (95% CI 1066.4-2287.6) and 1016.5 ml (95% CI 450.7-1582.3). The subgroup by stent type showed a decrease in the heterogeneity (I2 = 0.01%, I2 = 53.95%, I2 = 0.01%, and I2 = 54.41% for Thoraflex® Hybrid, E-vita®, Frozenix®, and Cronus®, respectively). The subgroup by chronicity of operation resulted in less heterogeneity among patients undergoing elective compared to non-elective operation (I2 = 29.22% versus I2 = 80.56% in non-elective). Meta-regression analysis showed that age and male gender significantly impacted on the reoperation for postoperative bleeding. Conclusions: The FET procedure for arch replacement is associated with coagulopathy and the transfusion of blood products. Male, age, and selective choice of FET use were identified as heterogeneity sources of reoperation for postoperative bleeding.

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