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EnglishAbstract OBJECTIVE: Extensive thoracic aortic aneurysms represent a challenging pathology in cardiac surgery. The frozen elephant trunk procedure, combining conventional surgery with endovascular techniques, allows single-stage treatment for such pathology. Here we present our surgical technique and results with the single-stage frozen elephant trunk procedure. METHODS: Between January 2007 and December 2009, 67 patients were treated with the frozen elephant trunk procedure in our institution. Mean age was 61 ± 11 years. Indications for surgery included chronic aneurysm (n = 22, 32.8%), acute type A dissection (n = 4, 6.0%), acute type B dissection (n = 2, 3.0%), chronic type A dissection (n = 30, 44.8%), and chronic type B dissection (n = 9, 13.4%). Thirty-six patients (53.7%) had undergone 38 previous cardiac or aortic operations. Thirty-two associated aortic and cardiac operations were performed. Brain protection was achieved by means of antegrade selective cerebral perfusion and moderate hypothermia (26°C) in all cases. RESULTS: In-hospital mortality was 13.4%. Postoperatively, permanent neurologic dysfunction (coma) occurred in 5 cases (7.5%), paraplegia in 2 (3.2%), and paraparesis in 3 (4.9%). Follow-up was 100% complete, with mean duration of 11.1 ± 8.4 months. The 1- and 2-year survivals were 76.7 ± 5.6% and 70.3 ± 8.0%, respectively. Ten patients (14.9%) required endovascular completion 2.3 ± 3.1 months after the first procedure, with 100% technical and procedural success. CONCLUSIONS: In contrast to the conventional elephant trunk technique, the frozen elephant trunk technique offers a potentially curative single-stage procedure for patients with extensive thoracic aortic disease, with encouraging short-term and midterm results.
| Titolo: | Complex thoracic aortic disease: single-stage procedure with the frozen elephant trunk technique |
| Autore/i: | DI BARTOLOMEO, ROBERTO; PACINI, DAVIDE; C. Savini; E. Pilato; MARTIN SUAREZ, SOFIA; DI MARCO, LUCA; DI EUSANIO, MARCO |
| Autore/i Unibo: | |
| Anno: | 2010 |
| Rivista: | |
| Pagina iniziale: | S81 |
| Pagina finale: | S85 |
| Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.jtcvs.2010.07.039 |
| Abstract: | Abstract OBJECTIVE: Extensive thoracic aortic aneurysms represent a challenging pathology in cardiac surgery. The frozen elephant trunk procedure, combining conventional surgery with endovascular techniques, allows single-stage treatment for such pathology. Here we present our surgical technique and results with the single-stage frozen elephant trunk procedure. METHODS: Between January 2007 and December 2009, 67 patients were treated with the frozen elephant trunk procedure in our institution. Mean age was 61 ± 11 years. Indications for surgery included chronic aneurysm (n = 22, 32.8%), acute type A dissection (n = 4, 6.0%), acute type B dissection (n = 2, 3.0%), chronic type A dissection (n = 30, 44.8%), and chronic type B dissection (n = 9, 13.4%). Thirty-six patients (53.7%) had undergone 38 previous cardiac or aortic operations. Thirty-two associated aortic and cardiac operations were performed. Brain protection was achieved by means of antegrade selective cerebral perfusion and moderate hypothermia (26°C) in all cases. RESULTS: In-hospital mortality was 13.4%. Postoperatively, permanent neurologic dysfunction (coma) occurred in 5 cases (7.5%), paraplegia in 2 (3.2%), and paraparesis in 3 (4.9%). Follow-up was 100% complete, with mean duration of 11.1 ± 8.4 months. The 1- and 2-year survivals were 76.7 ± 5.6% and 70.3 ± 8.0%, respectively. Ten patients (14.9%) required endovascular completion 2.3 ± 3.1 months after the first procedure, with 100% technical and procedural success. CONCLUSIONS: In contrast to the conventional elephant trunk technique, the frozen elephant trunk technique offers a potentially curative single-stage procedure for patients with extensive thoracic aortic disease, with encouraging short-term and midterm results. |
| Data prodotto definitivo in UGOV: | 4-feb-2011 |
| Appare nelle tipologie: | 4.01 Contributo in Atti di convegno |
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