Frozen elephant use in type a dissection: fundamentals, innovations, and pitfalls.
Expert Rev Med Devices
; 21(7): 579-586, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38841791
ABSTRACT
INTRODUCTION:
Type A acute aortic dissection (TA-AAD) is a great challenge for aortic surgeons. The establishment of a standardized surgical approach, particularly the determination of whether and when to address the aortic arch and the distal aorta in the same operation as the proximal aorta, is still unclear. AREAS COVERED Frozen elephant trunk (FET) has emerged as a valuable treatment for TA-AAD over the last decade. Here, we discuss the fundamentals and pitfalls of frozen elephant trunk procedures and present the latest innovations. EXPERT OPINION FET has the potential to simplify arch reconstruction in patients with complex arch tears and rupture, optimize perfusion in the distal true lumen for those with a compressed true lumen and malperfusion, address distal reentry tears, and promote false lumen thrombosis and late aortic remodeling. Nevertheless, FET is still associated with non-negligible mortality and morbidity rates. Patient selection, surgical expertise, and postoperative care remain crucial determinants in ensuring successful outcomes. Recent innovations in FET surgery involve the development of techniques to minimize or avoid hypothermic circulatory arrest and new FET devices with different arch branch configurations aiming to facilitate subsequent aortic reinterventions. We believe that both these advancements have the potential to improve patient outcomes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Disección Aórtica
Límite:
Humans
Idioma:
En
Revista:
Expert Rev Med Devices
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
TERAPEUTICA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Italia