Single Low-Volume Center Experience with Frozen Elephant Trunk in Acute Type A Aortic Dissections

AORTA

article

Luis F. López Almodóvar¹  Pedro Lima Cañadas¹  Andrés Enríquez Puga²  Irene Narváez Mayorga³  José A. Buendía Miñano¹  Marcelino Sánchez Casado⁴  Alfonso Cañas Cañas¹ 

[1] Department of Cardiac Surgery, Virgen de la Salud Hospital;Department of Radiology, Virgen de la Salud Hospital;Department of Cardiology, Virgen de la Salud Hospital;Department of Intensive Care Unit, Virgen de la Salud Hospital

关键词: aortic dissection;    aorta;    frozen elephant trunk;   

DOI  :  10.1055/s-0039-1677809

来源: Thieme

【 摘 要 】

Background Acute Type A aortic dissection (AAAD) is a surgical emergency. In patients with arch and descending aorta involvement (DeBakey Type I), a total aortic arch replacement with frozen elephant trunk (FET) could favor false lumen thrombosis and improve long-term results. The authors hereby present their experience with this technique in a single low-volume center, to assess whether the technique is feasible to treat such disease.Methods From January 2011 to December 2016, 43 patients with AAAD were operated on in the authors' institution, which carries out 300 to 350 annual procedures. Among these, 12 patients with an intimal tear in the aortic arch and/or proximal descending aorta received a FET procedure (10 males, age 57 years). Concomitant procedures were aortic valve replacement (42%), Bentall (25%), and aortic valve repair (17%).Results Cardiopulmonary bypass, cardiac arrest, and circulatory arrest times were 235 ± 43, 171 ± 33, and 75 ± 20 minutes, respectively. The operative mortality was 16.7% (n = 2). Stroke and re-thoracotomy for bleeding occurred in 8% (n = 1) and 8% (n = 1), respectively. There was no spinal cord injury. Follow-up was 36.1 months. During follow-up, no patients died or required a reoperation on the downstream aorta.Conclusion Although all patients were operated on in a low-volume center, the results with FET in AAAD are acceptable. Even though this technique demands high technical skills, it is a promising approach in patients with acute aortic dissection.

【 授权许可】

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