ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Early and mid-term results of frozen elephant trunk procedure for acute type A aortic dissection
Mustafa Akbulut1, Adnan Ak1, Özgür Arslan1, Davut Çekmecelioğlu1, Serpil Taş1, Arzu Antal Dönmez1, Mesut Şişmanoğlu1, Mehmet Altuğ Tuncer1
1Department of Cardiovascular Surgery, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2019.16879
Background: This study aims to investigate the early and mid-term results of total thoracic aorta repair with E-vita OPEN PLUS stent graft, which we used to remove the residual false lumen and prevent late-term complications in patients with acute type A aortic dissections.

Methods: The study included 41 patients (29 males, 12 females; mean age 51.9±10.4 years; range, 30 to 77 years) who underwent total thoracic aorta repair with frozen elephant trunk stent graft for acute type A aortic dissection between November 2013 and November 2017. The reduction in false lumen size and thrombosis were evaluated by repeated computed tomographyangiography on 10th day and third, sixth, and 12th months.

Results: Six patients (14.6%) were lost during hospital stay and one patient (2.4%) was lost during the follow-up period. Frozen elephant trunk stent graft"s distal end at descending aorta ended at T6, T7, and T8 levels in 15 (36.6%), 21 (51.2%), and five (12.2%) patients, respectively. The supra-aortic vessels were re-implanted separately in 21 (51.2%) or as island in 20 (48.8%) patients. Transient paraparesis (spinal cord ischemia) was observed in only one patient (2.4%), while permanent neurologic deficit (stroke or coma) was observed in two patients (4.9%). Mean duration of follow-up was 26.5±20.5 months. Computed tomography-angiography at first month showed that false lumen became thrombosed at rates of 93.9% and 54.5% at pulmonary trunk and diaphragmatic level, respectively.

Conclusion: We believe that total arcus repair in acute type A aortic dissection treatment with single-session frozen elephant trunk technique by ensuring early false lumen thrombosis is safe and successful.

Keywords : Aortic zones, false lumen, frozen elephant trunk, type A aortic dissection
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