Techniques and outcomes of total aortic arch repair with frozen elephant trunk for DeBakey I dissections.
J Cardiovasc Surg (Torino)
; 61(4): 392-401, 2020 Aug.
Article
in En
| MEDLINE
| ID: mdl-32319274
Total aortic arch replacement (TAR) with frozen elephant trunk (FET) technique (FET) has been increasingly used to treat a variety of aortic pathologies over the past two decades. Because FET can effectively treat the diseased arch and cover the proximal entry tear in the distal arch, it is a valuable option in the treatment of DeBakey I aortic dissections. This report focuses on the techniques and outcomes of TAR with FET for acute/chronic aortic dissection. A review of pooled literature including 27 observational studies showed in-hospital mortality, permanent stroke, and spinal cord injury rates of 8.4%, 5.9% and 2.6% for acute aortic dissections, and 7.5%, 4.0% and 4.6% for chronic aortic dissections, respectively. In most of the studies, complete false lumen thrombosis rate was achieved in 80% of patients at the level of FET for acute and chronic aortic dissections. Mid-term outcomes are equally promising. For chronic aortic dissections, positive remodeling of the non-stented distal aortic segments is less frequent leading to secondary reinterventions within 3 to 5 years. However, most studies have not applied distal abdominal extensions of the repair using fenestrated and branched endografts. In the current endovascular era, TAR + FET should be considered as an alternative to conventional open surgical repair in centers of excellence.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aorta, Thoracic
/
Blood Vessel Prosthesis
/
Aortic Aneurysm, Thoracic
/
Blood Vessel Prosthesis Implantation
/
Endovascular Procedures
/
Aortic Dissection
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
J Cardiovasc Surg (Torino)
Year:
2020
Document type:
Article
Affiliation country:
United States
Country of publication:
Italy