Aortic diameter remodelling after the frozen elephant trunk technique in aortic dissection: results from an international multicentre registry†

Abstract

The FET technique provides an effective treatment for AoD, promoting FL thrombosis and remodelling in the descending thoracic aorta. Changes in the diameter of the aortic lumen depend mainly on the status of the FL and are similar between acute and chronic AoD. Changes in the diameter of true lumen are affected by both the FL status and the timing of the presentation. However, increased FL thrombosis and positive remodelling rates are not maintained at the level of the abdominal aorta, and strict follow-up is mandatory to detect early changes in the aortic dimensions, which may warrant further interventions.

Total arch replacement and frozen elephant trunk for type A aortic dissection after Bentall procedure in Marfan syndrome

“…A recent study has found that at the time of initial repair for TAAD in MFS, a more aggressive surgical approach seems to be superior to limited repair (29). However, there is scarce data on the long-term outcomes of such extensive repair for TAAD in such patients (19,22,30). The current cohort expanded the special subset of MFS patients in our experience (17,22,31), who, following a prior Bentall procedure, developed TAAD involving the arch, which was repaired in a reoperative setting with the extensive FET technique.…”

Editor's Choice – Current Options and Recommendations for the Treatment of Thoracic Aortic Pathologies Involving the Aortic Arch: An Expert Consensus Document of the European Association for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular Surgery (ESVS)

“…Particularly in acute aortic dissection, a progressive false lumen thrombosis, seen in more than 90% of patients, followed by shrinkage and positive remodelling, has been reported from several studies. 162,163 The potential exclusion of the downstream aortic pathology occurs predominantly up to the distal end of the stent graft, so that FET can be applied curatively only in association with the extension of…”

Image Predictors of Treatment Outcome after Thoracic Aortic Dissection Repair

“…No consensus exists about which parameter or parameters (diameter, area, volume, or absolute ratio between the two lumina) should be used to define aortic remodeling (10,(51)(52)(53). Some investigators proposed use of a 10% volumetric difference to define substantial changes in aortic size, also known as remodeling (52,54).…”