Abstract OBJECTIVE: The purpose of this study was to examine our experience with the frozen elephant trunk in patients with chronic aortic dissection. METHODS: In our Institution, between January 2007 and August 2010, 49 patients (mean age: 59.6 ± 9.0 years) underwent total arch replacement with the frozen elephant trunk technique for chronic aortic dissection (type A, n=2; residual type A, n=37; type B, n=10). Forty patients (81.6%) patients had undergone previous cardiovascular procedures. Associated cardiac procedures were indicated in 21 (42.8%) patients. Brain protection was achieved with antegrade selective cerebral perfusion in all cases. RESULTS: Hospital mortality (n=5) was 10.2%. Postoperative serious complications included coma (n=3; 6.1%), paraplegia (n=2; 4.1%), respiratory failure (n=6; 12.2%), and definitive dialysis (n=2; 4.1%). Follow-up was 100% completed (mean period: 12.9 ± 11.7 months). The estimated 1- and 3-year survival rates were 91.2 ± 4.2% and 81.6 ± 6.5%, respectively. Endovascular extension was required in 11 (22.4%) patients, with technical success of 100%. Complete thrombosis of the peri-stent false lumen was achieved in 82.9% of cases, with significant reduction of the false lumen diameter (preoperative: 36 ± 11 mm; postoperative: 24 ± 17 mm; p=0.001) and increase of the true lumen diameter (preoperative: 15 ± 5 mm; postoperative: 26 ± 6 mm; p=0.001). CONCLUSIONS: The frozen elephant trunk technique, allowing treatment of extensive disease of the thoracic aorta, was associated with encouraging short- and midterm results. Longer-term follow-up is warranted.

Short- and midterm results after hybrid treatment of chronic aortic dissection with the frozen elephant trunk technique / Di Eusanio M; Armaro A; Di Marco L; Pacini D; Savini C; Martin Suarez S; Pilato E; Di Bartolomeo R. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - STAMPA. - 40:(2011), pp. 875-880. [10.1016/j.ejcts.2011.01.068]

Short- and midterm results after hybrid treatment of chronic aortic dissection with the frozen elephant trunk technique

DI EUSANIO, MARCO;ARMARO, ALESSANDRO;DI MARCO, LUCA;PACINI, DAVIDE;SAVINI, CARLO;MARTIN SUAREZ, SOFIA;DI BARTOLOMEO, ROBERTO
2011

Abstract

Abstract OBJECTIVE: The purpose of this study was to examine our experience with the frozen elephant trunk in patients with chronic aortic dissection. METHODS: In our Institution, between January 2007 and August 2010, 49 patients (mean age: 59.6 ± 9.0 years) underwent total arch replacement with the frozen elephant trunk technique for chronic aortic dissection (type A, n=2; residual type A, n=37; type B, n=10). Forty patients (81.6%) patients had undergone previous cardiovascular procedures. Associated cardiac procedures were indicated in 21 (42.8%) patients. Brain protection was achieved with antegrade selective cerebral perfusion in all cases. RESULTS: Hospital mortality (n=5) was 10.2%. Postoperative serious complications included coma (n=3; 6.1%), paraplegia (n=2; 4.1%), respiratory failure (n=6; 12.2%), and definitive dialysis (n=2; 4.1%). Follow-up was 100% completed (mean period: 12.9 ± 11.7 months). The estimated 1- and 3-year survival rates were 91.2 ± 4.2% and 81.6 ± 6.5%, respectively. Endovascular extension was required in 11 (22.4%) patients, with technical success of 100%. Complete thrombosis of the peri-stent false lumen was achieved in 82.9% of cases, with significant reduction of the false lumen diameter (preoperative: 36 ± 11 mm; postoperative: 24 ± 17 mm; p=0.001) and increase of the true lumen diameter (preoperative: 15 ± 5 mm; postoperative: 26 ± 6 mm; p=0.001). CONCLUSIONS: The frozen elephant trunk technique, allowing treatment of extensive disease of the thoracic aorta, was associated with encouraging short- and midterm results. Longer-term follow-up is warranted.
2011
Short- and midterm results after hybrid treatment of chronic aortic dissection with the frozen elephant trunk technique / Di Eusanio M; Armaro A; Di Marco L; Pacini D; Savini C; Martin Suarez S; Pilato E; Di Bartolomeo R. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - STAMPA. - 40:(2011), pp. 875-880. [10.1016/j.ejcts.2011.01.068]
Di Eusanio M; Armaro A; Di Marco L; Pacini D; Savini C; Martin Suarez S; Pilato E; Di Bartolomeo R
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/101979
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