ObjectiveReport initial experience with the Frozen Elephant Trunk technique.MethodsFrom July 2009 to October 2013, Frozen Elephant Trunk technique was performed
in 21 patients (66% male, mean age 56 ±11 years). They had type A
aortic dissection (acute 9.6%, chronic 57.3%), type B (14.3%, all chronic)
and complex aneurysms (19%). It was 9.5% of reoperations and 38% of
associated procedures (25.3% miocardial revascularization, 25.3% replacement
of aortic valve and 49.4% aortic valved graft). Aortic remodeling was
evaluated comparing preoperative and most recent computed tomography scans.
One hundred per cent of complete follow-up, mean time of 28 months.ResultsIn-hospital mortality of 14.2%, being 50% in acute type A aortic dissection,
8.3% in chronic type A aortic dissection, 33.3% in chronic type B aortic
dissection and 0% in complex aneurysms. Mean times of cardiopulmonary bypass
(152±24min), myocardial ischemia (115±31min) and selective
cerebral perfusion (60±15min). Main complications were bleeding
(14.2%), spinal cord injury (9.5%), stroke (4.7%), prolonged mechanical
ventilation (4.7%) and acute renal failure (4.7%). The need for second-stage
operation was 19%. False-lumen thrombosis was obtained in 80%.ConclusionFrozen Elephant Trunk is a feasible technique and should be considered. The
severity of the underlying disease justifies high mortality rates. The
learning curve is a reality. This approach allows treatment of more than two
segments at once. Nonetheless, if a second stage is made necessary, it is
facilitated.
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