2013
DOI: 10.1093/ejcts/ezt493
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Abstract: Several studies have shown that after DeBakey type 1 acute aortic dissection (DB1-AAD) surgery, 70% of the surviving patients still present with a dissected distal aorta that can eventually dilate, rupture, lead to distal malperfusion or require secondary extensive interventions. In order to minimize these complications, different surgeons have advocated total thoracic aorta remodelling procedures during primary aortic repair to promote false-lumen obliteration and distal thrombosis. Such management, which inc… Show more

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Cited by 42 publications
(43 citation statements)
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“…One-year survival ranged from 79% to 100%, 5-year survival ranged from 68% to 96% and 1-year freedom from re-intervention from 72% to 100% (41-47). In the above mentioned metaanalysis, the pooled average of aortic remodelling, indicated by a partial or complete thrombosis of the persistent DTA false lumen, was 88.9% (26). Despite this imaging data comparing favourably with the imaging data reported for conservative management (20,48), a substantial survival benefit of the FET techniques has yet to be demonstrated, and more robust data is necessary to standardize new paradigms of treatment in patients with acute dissection.…”
Section: Current Evidencementioning
confidence: 97%
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“…One-year survival ranged from 79% to 100%, 5-year survival ranged from 68% to 96% and 1-year freedom from re-intervention from 72% to 100% (41-47). In the above mentioned metaanalysis, the pooled average of aortic remodelling, indicated by a partial or complete thrombosis of the persistent DTA false lumen, was 88.9% (26). Despite this imaging data comparing favourably with the imaging data reported for conservative management (20,48), a substantial survival benefit of the FET techniques has yet to be demonstrated, and more robust data is necessary to standardize new paradigms of treatment in patients with acute dissection.…”
Section: Current Evidencementioning
confidence: 97%
“…To reduce the frequency of late aneurysm formation and reoperation, some surgeons have been motivated to perform more aggressive primary operations, all associated with strengths and weaknesses. Recently, total arch replacement (TAR) and concomitant antegrade stenting of the DTA with a frozen elephant trunk (FET) has emerged as an interesting form of treatment for patients with extensive DBT1-AAD, and its application has significantly increased over recent years (26). Different methods of how to perform this procedure have been described, but the common feature is that, under hypothermic circulatory arrest, the stent graft is delivered antegradely into the DTA through the open aorta and sutured into position while the transverse arch is replaced with a Dacron graft.…”
Section: Perspectivementioning
confidence: 99%
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“…Some surgeons advocate a more conservative tear oriented approach (hemiarch replacement) to reduce postoperative mortality and morbidity (1). On the other hand, other authors support a more aggressive approach for AAAD, mainly consisting of total arch replacement with or without the use of the frozen elephant trunk (FET) or classic elephant trunk (ET) technique (2)(3)(4)(5). The rationale behind this more invasive operation is to mitigate the risk of late aneurysm formation at the distal aorta and to avoid distal malperfusion due to the compression of the true lumen.…”
Section: Introductionmentioning
confidence: 99%