IP009. Thoraflex Graft in an Inverted Position for Postdissection Thoracoabdominal Aneurysm: Reversed Frozen Elephant Trunk

Ravaux, Justine M.; Rémy, Philippe; Detroux, Marc; Torella, Francesco; Swaelens, Charles

doi:10.1016/j.jvs.2019.04.130

Cited by 1 publication

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“…Despite its initial purpose for distal aortic arch aneurysms, the international experience shows the versatile use of this prosthesis for all kinds of applications, such as penetrating aortic ulcers involving the aortic arch ( 21 , 22 ). There are several reports where this prosthesis was even used upside down (reversed) for vascular surgery or post-dissection and thoracoabdominal aneurysm ( 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Single-Center Experience With the Thoraflex™ Hybrid Prosthesis: Indications, Implantation Technique and Results

Kuczyńska

Motekallemi

Oberhuber

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveThe aim of this study was to evaluate the early and mid-term results after the frozen elephant trunk (FET) procedure for the treatment of complex arch and proximal descending aortic disease in a single-center institution.MethodsFrom April 2015 to July 2021, 72 patients (25 women, 60.4 ± 10.3 years) underwent Thoraflex™ Hybrid implantation at our institution. The indications were thoracic aortic aneurysm (TAA) (n = 16, 22.2%), post-dissection aneurysm (n = 21, 29.2%), and acute aortic dissection (AAD) (n = 35, 48.6%). Antegrade cerebral perfusion under moderate hypothermia (28°C) was employed in all cases. Eighteen patients (25%) have already been operated due to heart or aortic disease.ResultsOverall in-hospital mortality was 12.5% (9 patients). Rates of permanent neurological dysfunction and spinal cord injury were 9.7 and 5.5%, respectively. The in-hospital mortality rate among patients operated on AAD, TAA, and post-dissection aneurysm were 8.6, 6.2, and 23.8%, respectively. At a mean follow-up of 26 ± 20 months, mortality was 9.7%. Furthermore, 23 patients (31.9%) required a subsequent procedure in distal aorta: endovascular stentgraft extension in 19 patients (26.4%) and open aortic surgery in 4 patients (5.5%). The mid-term survival of patients with type A aortic dissection was 97%.ConclusionsOur experience with the Thoraflex Hybrid prosthesis demonstrates its surgical applicability for different types of aortic pathologies with promising outcomes during early and midterm follow-up. Our technique and perioperative management lead to comparable or even superior neurological outcomes and mortality in urgent cases considering other high-volume centers.

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