There were multiple factors predicting the risk of SCI after the FET technique. Paraplegia may be prevented by avoiding deep insertion of the stent graft and by keeping blood pressure elevated after the operation.

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp and postoperative complications and requirements, have been evaluated as predictors of POAF; however, most of these predictors were not consistent among studies and only advanced age was a consistent predictor. 6 Recently, echocardiographic assessments have achieved much better prediction of POAF by measuring the left atrium-related values including the left atrial volume index (LAVI), LA strain and total atrial conduction time (TACT). Although there are several measurements of TACT, the time interval from the P-wave onset on the electrocardiogram (ECG) to the peak of the A' lateral wave on TDI (PA-TDI duration) provides a reliable estimation of TACT, and the PA-TDI duration has been shown to be significantly related to new-onset AF. 7,8 Our previous study revealed that the PA-TDI duration was predictive of AF in patients undergoing off-pump coronary artery bypass grafting (CABG). 9 trial fibrillation (AF) is a common complication after cardiac surgery, occurring in 10-65% of the patients. 1 Several studies have found adverse outcomes associated with postoperative AF (POAF), including increased risk of hospital stay, higher risk of stroke, permanent pacemaker implantation, and increased in-hospital and long-term mortality rates. 2 The incidence of POAF is higher with valvular surgery. 3 Obviously, in aortic valve (AV) surgery, the incidence of AF is related to these postoperative complications. 4 Moreover, Filardo et al reported that new-onset POAF was significantly associated with increased long-term risk of mortality in patients undergoing AV replacement (AVR) surgery. 5 These results indicate that POAF should be prevented and controlled postoperatively.In the past 2 decades, many clinical variables, including preoperative characteristics, comorbidities, intraoperative findings A

The cryo-maze procedure was rather effective for eliminating chronic AF associated with both mitral and tricuspid valve disease, but there were a few cases with new atrial tachycardia. The box pulmonary vein isolation was useful in solitary mitral valve cases.

In this study, we report our experience using the frozen elephant trunk (FET) technique for chronic aortic dissection. Methods: Between January 2011 and December 2017, 15 patients underwent total arch replacement (TAR) with the FET technique for chronic aortic dissection (CAD). Results: Hospital mortality was 6.7% (n=1). No patients experienced spinal cord injury. Distal stent-induced new entry (dSINE) occurred in the early postoperative period in one patient. There were four unplanned additional operations to manage dSINE. Five patients suffered from dSINE, and aortoesophageal fistula developed in three of them. Short insertion length of the FET and large angle between the distal edge of the FET and the descending aorta were significantly more common in the dSINE group than in the non-dSINE group. The cumulative survival rates at 1, 3, and 5 years were 93.3%, 93.3%, and 66.4%, respectively. The cumulative aortic event-free rates at 1, 2, and 3 years were 85.7%, 77.1%, and 52.9%, respectively. Conclusion:The FET technique for CAD provided good early results. Short insertion length of the FET, however, can induce dSINE, which requires an additional operation at mid-term. Thus, surgical indication of the FET technique for CAD must be discussed.

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