Analysis of Spinal Ischemia after Frozen Elephant Trunk for Acute Aortic Dissection: An Observational, Single-Center Study

Cuellar, Frederico Lomonaco; Oberhuber, Alexander; Martens, Sven; Rukosujew, Andreas; Marchiori, Elena; Ibrahim, Abdulhakim

doi:10.3390/diagnostics12112781

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…Additionally, paraplegia is a serious complication and occurred in two patients in the c-TAR group. In addition, the prolonged duration of SCP and LBCA, extensive stent coverage of the intercostal arteries associated with a lower distal landing zone of the stent graft (Th 7–10) are strong risk factors of paraplegia ( 20 ). With our technique, the SCP and LBCA times are significantly shorter, and the proximal end of the stented graft is “moved forward” and positioned just proximal to the origin of the innominate artery, resulting in limited sacrifice of intercostal arteries and avoiding extensive coverage of the descending aorta.…”

Section: Discussionmentioning

confidence: 99%

Simplified total arch reconstruction with a stented graft for extended aortic arch dilation

Zheng¹,

Yu²,

Lin³

et al. 2023

J Thorac Dis

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Background: Reconstruction of the aortic arch and its three supra-aortic vessels remains a great surgical challenge with postoperative complications. We present a simplified total arch reconstruction with a modified stent graft (s-TAR) and compared its operative outcomes with conventional total arch replacement (c-TAR).Methods: This retrospective analysis of prospectively collected data from all consecutive patients who had ascending aortic aneurysm with extended aortic arch dilation and underwent simultaneous ascending aorta replacement and aortic arch reconstruction with the s-TAR or c-TAR between 2018 and 2021. The indication for intervention was maximum diameter of ascending aorta >55 mm and aortic arch in zone II >35 mm.Results: A total of 84 patients were analyzed: 43 in the s-TAR group and 41 in the c-TAR group. No inter-group differences were found for sex, age, comorbidities, or EuroSCORE II results. All patients were successfully treated with s-TAR or c-TAR, and none died intraoperatively. Cardiopulmonary bypass, selective cerebral perfusion, and lower-body circulatory arrest time were significantly shorter in the s-TAR group, which also had a lower incidence of prolonged ventilation and transient neurologic dysfunction. No patient in either group experienced permanent neurologic dysfunction. The incidence of recurrent laryngeal nerve injury and paraplegia was markedly increased in the c-TAR group; however, no such events were observed in the s-TAR group. Both perioperative blood loss and the incidence of reoperation for bleeding were significantly lower in the s-TAR group. The in-hospital mortality rate was 0% in the s-TAR group and 4.9% in the c-TAR group. The s-TAR group had significantly shorter ICU stay and lower total hospitalization costs. Conclusions:The s-TAR technique is a safe and effective alternative for total arch reconstruction with shorter operation time, lower rate of postoperative complications and lower total hospitalization costs compared with c-TAR.

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Section: Discussionmentioning

confidence: 99%