scholarly journals Long-term outcomes of total arch replacement with the non-frozen elephant trunk technique for Stanford Type A acute aortic dissection†

2018 ◽  
Vol 27 (3) ◽  
pp. 455-460 ◽  
Author(s):  
Yosuke Inoue ◽  
Hitoshi Matsuda ◽  
Atsushi Omura ◽  
Yoshimasa Seike ◽  
Kyokun Uehara ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Total Arch Replacement ◽  
Frozen Elephant Trunk ◽  
Long Term Outcomes ◽  
Elephant Trunk ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

scholarly journals Efficacy of entry exclusion strategy for DeBakey type III retrograde Stanford type A acute aortic dissection

2020 ◽  
Author(s):  
Yosuke Inoue ◽  
Hitoshi Matsuda ◽  
Jiro Matsuo ◽  
Takayuki Shijo ◽  
Atsushi Omura ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Type Iii ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

Abstract OBJECTIVES Resection of a primary entry tear is essential for the treatment of Stanford type A acute aortic dissection (AAAD). In DeBakey type III retrograde AAAD (DBIII-RAAAD), resection of the primary entry tear in the descending aorta is sometimes difficult. The frozen elephant trunk technique and thoracic endovascular aortic repair (TEVAR) enable the closure of the primary entry in the descending aorta. The aim of this study was to investigate the efficacy of resection or closure of primary entry, i.e. entry exclusion, in patients with DeBakey type III retrograde-AAAD. METHODS The medical records of 654 patients with AAAD who underwent emergency surgery between January 2000 and March 2019 were retrospectively reviewed, and 80 eligible patients with DeBakey type III retrograde-AAAD were divided into the excluded (n = 50; age, 62 ± 12 years) and residual (n = 30; age, 66 ± 14 years) groups according to postoperative computed tomography angiographic data of the false lumen around the primary entry. The excluded group was defined as having a postoperative false lumen at the level of the elephant trunk or thrombosis of the endograft including primary entry. Patients with early false lumen enhancement around the elephant trunk or an unresected primary entry tear after isolated hemiarch replacement were included in the residual group. The early and long-term surgical outcomes were compared between the groups. RESULTS The in-hospital mortality rate was 8% (6/80), with no significant difference observed between the excluded and the residual groups (10% and 7%, respectively; P > 0.99). Ninety-five percentage of the patients (20/21) achieved entry exclusion with stent grafts including the frozen elephant trunk procedure and TEVAR. Spinal cord ischaemia was not observed in either group. The cumulative overall survival at 5 years was comparable between the 2 groups (76% and 81% in the excluded and residual groups, respectively; P = 0.93). The 5-year freedom from distal aortic reoperation rate was significantly higher in the excluded group (97%) than in the residual group (97% vs 66%; P = 0.008). CONCLUSIONS Not only resection but also closure using the entry exclusion approach for DeBakey type III retrograde-AAAD utilizing new technologies including the frozen elephant trunk technique and TEVAR might mitigate dissection-related reoperations.

scholarly journals Early and mid-term outcomes of total arch replacement with the frozen elephant trunk technique for type A acute aortic dissection

2019 ◽  
Vol 29 (5) ◽  
pp. 753-760 ◽  
Author(s):  
Akira Furutachi ◽  
Masanori Takamatsu ◽  
Eijiro Nogami ◽  
Kohei Hamada ◽  
Junji Yunoki ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Total Arch Replacement ◽  
Lumen Area ◽  
Frozen Elephant Trunk ◽  
True Lumen ◽  
Elephant Trunk ◽  
Elephant Trunk Technique

Abstract OBJECTIVES The aim of this study was to evaluate the outcomes of the frozen elephant trunk (FET) technique, using the J Graft FROZENIX for Stanford type A acute aortic dissection, in comparison with the unfrozen elephant trunk technique. METHODS Between January 2010 and August 2018, we performed total arch replacement for Stanford type A acute aortic dissection in our hospital. Thirty patients were treated by the elephant trunk procedure (ET group), and 20 patients were treated by the FET procedure (FET group). To evaluate aortic remodelling, we measured the area of the aorta, the true lumen and the false lumen at 12 months of follow-up. RESULTS Preoperative characteristics and operation time were not significantly different between the 2 groups. The quantity of blood transfused was much greater in the ET group than in the FET group. Resection or closure of the most proximal entry tear was obtained in 73.3% (22 out of 30 patients) in the ET group and 100% (20 out of 20 patients) in the FET group (P = 0.015). There was no case that had recurrent nerve palsy or paraplegia in the FET group. Stent graft-induced new entry occurred in 3 cases (15.8%) in the FET group. There were no significant differences between the 2 groups in aortic area, true lumen area or false lumen area. CONCLUSIONS Total arch replacement with the FET technique in Stanford type A acute aortic dissection carries a risk of distinct complications; however, with thorough advance planning, it should be possible to safely institute this treatment. Further randomization, with a comparison of each technique, is required to provide clear conclusions whether the FET is useful for acute Stanford type A aortic dissection.

scholarly journals Long-term outcomes of frozen elephant trunk for type A aortic dissection in patients with Marfan syndrome

2017 ◽  
Vol 154 (4) ◽  
pp. 1175-1189.e2 ◽  
Author(s):  
Wei-Guo Ma ◽  
Wei Zhang ◽  
Jun-Ming Zhu ◽  
Bulat A. Ziganshin ◽  
Ai-Hua Zhi ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Type A ◽  
Frozen Elephant Trunk ◽  
Long Term Outcomes ◽  
Elephant Trunk ◽  
Type A Aortic Dissection

scholarly journals Outcome of Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection

Medicine ◽  
2015 ◽  
Vol 94 (16) ◽  
pp. e694 ◽  
Author(s):  
Hui-Han Lin ◽  
Shou-Fu Liao ◽  
Ching-Feng Wu ◽  
Ping-Chun Li ◽  
Ming-Li Li
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique
Sign in / Sign up

Export Citation Format

Share Document