scholarly journals Quality of life: modified triple-branched stent graft implantation versus frozen elephant trunk technique

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zeng-Rong Luo ◽  
Mi-Rong Tang ◽  
Jia-Hui Li ◽  
Liang-Wan Chen ◽  
Liang-Liang Yan
Keyword(s):  
Stent Graft ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Role Physical ◽  
Perceived Burden ◽  
Group A ◽  
Elephant Trunk Technique ◽  
Group B ◽  
Stent Graft Implantation ◽  
Graft Implantation

Abstract Objective To compare the effects of modified triple-branched stent implantation and frozen elephant trunk technique on the quality of life (QoL) of acute Stanford Type A aortic dissection (AAAD) patients at different follow-up times. Methods Data from 175 AAAD survivors was collected which were divided into two groups according to different surgical techniques: (group A): modified triple-branched stent graft implantation; (group B): frozen elephant trunk. The SF-36 were used to assess the QoL at discharge (AD), the third postoperative month (POM3), and the twelfth postoperative month (POM12). Results (1) The total scores at each time of both groups showed lower than the normal level; Group A scored higher than group B at some time points in terms of some items (role physical, role emotion and mental health; all P = 0.000), and some items at POM3 or POM12 scored higher than at discharge (role physical, social function; both P = 0.000). (2) There were less patients with heavy self-perceived burden in group A than group B at discharge (P = 0.032) and patients with heavy self-perceived burden decreased over time. (3) Young postoperative AAD patients (P = 0.002) in group B (P = 0.005) with heavy self-perceived burden (P = 0.000), acute renal failure (P = 0.008), long LOS (P = 0.026) and blood loss (> 1000 mL/24 h) (P = 0.039) seemed to get a worse QoL. Conclusion The impact on QoL of the modified triple-branched stent graft implantation technique seemed to be better than those of frozen elephant trunk surgery in role physical, role emotion and mental health.

scholarly journals Quality of Life: Modified Triple-branched Stent Graft Implantation Versus Frozen Elephant Trunk Technique

2021 ◽  
Author(s):  
Zeng-Rong Luo ◽  
Mi-Rong Tang ◽  
Jia-Hui Li ◽  
Liang-Wan Chen ◽  
Liang-Liang Yan
Keyword(s):  
Stent Graft ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Role Physical ◽  
Perceived Burden ◽  
Group A ◽  
Elephant Trunk Technique ◽  
Group B ◽  
Stent Graft Implantation ◽  
Graft Implantation

Abstract Objective: To compare the effects of modified triple-branched stent implantation and frozen elephant trunk technique on the quality of life (QoL) of acute Stanford Type A aortic dissection (AAAD) patients at different follow-up times.Methods: Data from 175 AAAD survivors was collected which were divided into two groups according to different surgical techniques: (group A): modified triple-branched stent graft implantation; (group B): frozen elephant trunk. The SF-36 were used to assess the QoL at discharge(AD), the third postoperative month (POM3), and the twelfth postoperative month (POM12).Results: (1)The total scores at each time of both groups showed lower than the normal level; Group A scored higher than group B at some time points in terms of some items (role physical, role emotion and mental health; all P=0.000), and some items at POM3 or POM12 scored higher than at discharge (role physical, social function; both P=0.000). (2) There were less patients with heavy self-perceived burden in group A than group B at discharge (P=0.032) and patients with heavy self-perceived burden decreased over time. (3) Young postoperative AAD patients (P=0.002) in group B (P=0.005) with heavy self-perceived burden (P=0.000) , acute renal failure (P=0.008) , long LOS (P=0.026) and blood loss（> 1000 mL / 24h）(P=0.039) seemed to get a worse QoL. Conclusion: The impact on QoL of the modified triple-branched stent graft implantation technique seemed to be better than those of frozen elephant trunk surgery in role physical, role emotion and mental health.

scholarly journals Reversed Frozen Elephant Trunk Technique to Treat a Type II Thoracoabdominal Aortic Aneurysm

2016 ◽  
Vol 24 (2) ◽  
pp. 277-280 ◽  
Author(s):  
E. Sebastian Debus ◽  
Tilo Kölbel ◽  
Sabine Wipper ◽  
Holger Diener ◽  
Beate Reiter ◽  
...  
Keyword(s):  
Stent Graft ◽  
Spinal Cord Ischemia ◽  
False Lumen ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aortic Aneurysms ◽  
Hybrid Technique ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Elephant Trunk Technique ◽  
Frozen Elephant Trunk Technique

Purpose: To describe a hybrid technique of reversed frozen elephant trunk to treat thoracoabdominal aortic aneurysms (TAAA) through an abdominal only approach. Technique: The technique is demonstrated in a 29-year-old Marfan patient with a chronic type B aortic dissection previously treated with a thoracic stent-graft who presented with a thoracoabdominal false lumen aneurysm. Through an open distal retroperitoneal approach to the abdominal aorta, a frozen elephant trunk graft was implanted over a super-stiff wire upside down with the stent-graft component in the thoracic aorta. Following deployment of the stent-graft proximally and preservation of renovisceral perfusion in a retrograde manner, the renovisceral vessels were sequentially anastomosed to the elephant trunk graft branches, thus reducing the ischemia time of the end organs. The aortic sac was then opened, and the distal part of the hybrid graft was anastomosed with a further bifurcated graft to the iliac vessels. Conclusion: The reversed frozen elephant trunk technique is feasible for hybrid treatment of TAAAs via an abdominal approach only. This has the benefit of substantially reducing the trauma of thoracic exposure, thus preserving major benefits of open thoracoabdominal surgery, such as the presence of short bypasses to the renovisceral vessels and reimplantation of lumbar arteries to reduce spinal cord ischemia.

Is total aortic arch replacement with the frozen elephant trunk procedure reasonable in elderly patients?

2021 ◽  
Author(s):  
Erik Beckmann ◽  
Andreas Martens ◽  
Tim Kaufeld ◽  
Ruslan Natanov ◽  
Heike Krueger ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Younger Patients ◽  
Total Aortic Arch Replacement ◽  
Group A ◽  
Group B ◽  
Over Time

Abstract OBJECTIVES Total aortic arch replacement is an invasive procedure with significant risks for complications. These risks are even higher in older, multimorbid patients. The current trends in demographic changes in western countries with an ageing population will aggravate this issue. In this study, we present our experience with total aortic arch replacement using the frozen elephant trunk (FET) technique in septuagenarians. We compared the results of septuagenarians with those of younger patients and analysed if there was an improvement in outcome over time. METHODS Between August 2001 and March 2020, 225 patients underwent non-urgent FET procedure at our institution. There were 75 patients aged ≥70 years (mean age 74 ± 4) who were assigned to group A, and 150 patients aged <70 years (mean age of 57 ± 11) who were assigned to group B. In groups A and B, the indications for surgery were chronic dissection (21% vs 53%), aortic aneurysm (78% vs 45%) and penetrating atherosclerotic ulcer (1% vs 2%). RESULTS The rate for temporary dialysis was significantly higher in group A than in group B (29% vs 13%, P = 0.003), although the majority recovered kidney function. Rates for re-exploration for bleeding and stroke were comparable in both groups. In-hospital mortality was significantly higher in group A than in group B (24% vs 13%, P = 0.037). Logistic regression analysis showed that age >70 years was an independent statistically significant risk factor for in-hospital mortality (odds ratio = 2.513, 95% confidence interval = 1.197–5.278, P-value = 0.015). Follow-up was complete for 100% of patients and comprised a total of 1073 patient-years with a mean follow-up time of 4.8 ± 4.5 years. The 1- and 5-year survival rates were 68% and 49% in group A, and 85% and 71% in group B, respectively (log rank, P < 0.001). Survival did not significantly improve over time. Discussion Total aortic arch replacement using the FET technique has a significantly higher risk for perioperative morbidity and mortality in septuagenarians than in younger patients. Long-term survival is significantly impaired in older patients. We recommend thorough patient selection of those who require total aortic arch replacement, and optimization of perioperative management to improve outcomes.

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