Multicentre frozen elephant trunk technique experience as redo surgery to treat residual type A aortic dissections following ascending aortic replacement

Maximilian Kreibich, Leonard Pitts, Jörg Kempfert, Murat Yildiz, Florian Schönhoff, Christopher Gaisendrees, Maximilian Luehr, Tim Berger, Till Demal, Joshua Jahn, Jamila Kremer, Julia Dumfarth, Michael Grimm, Philipp Pfeiffer, Daniel Sebastian Dohle, Zara Dietze, Sergey Leontyev, Andreas Voetsch, Philipp Krombholz-Reindl, Felix NagelAndrea Finster, Martin Czerny, Christian Detter

Publikation: Beitrag in Fachzeitschrift (peer-reviewed)Artikel in Fachzeitschrift

Abstract

OBJECTIVES: To assess the efficacy of reoperative frozen elephant trunk (FET) surgery for treating residual type A aortic dissections.

METHODS: Between 04/2015 and 10/2023, 237 patients underwent elective redo surgical aortic arch replacement via the FET technique to treat residual type A aortic dissection in eleven European aortic centres. Data were pooled and analysed retrospectively.

RESULTS: The time between an acute type A dissection repair to FET implantation was 5 [1, 9] years. More than half of all patients (54%) presented with an entry within the aortic arch, and 174 patients (73%) presented residual dissections of supra-aortic vessels During FET repair, the axillary artery was cannulated in 181 patients (76%), while 83 patients (35%) underwent additional cardiac procedures including 39 root replacements (16%) and 15 coronary bypass procedures (6%). Zone 2 was the most common arch anastomosis site (n = 163, 69%) and bilateral antegrade cerebral perfusion was most frequent (n = 159, 67%). Fifteen patients (6%) suffered in-hospital mortality. Age in years (p < 0.001, OR: 1.069) proved to be predictive for overall mortality in our COX regression model.

CONCLUSIONS: Elective redo surgical aortic arch replacement using the FET technique for treating residual type A aortic dissection following ascending aortic replacement revealed a favourable outcome. The decision to undertake stage-two therapy of a residually dissected aortic arch should be made by an aortic team on a patient-by-patient basis.

OriginalspracheEnglisch
Aufsatznummerezae401
FachzeitschriftEuropean Journal of Cardio-thoracic Surgery
Jahrgang66
Ausgabenummer5
DOIs
PublikationsstatusElektronische Veröffentlichung vor Drucklegung - 08 Nov. 2024

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