Usage of elephant trunk stent‐graft in type 1 aortic dissections: How necessary is this?

Abstract

We congratulate Rezaei et al. 1 for their successful series. Many papers deal with the effective use of elephant trunk stent-graft in aortic dissections as the authors mentioned as well. 2,3 Likewise, this ap-

Frozen elephant trunk the way to go in acute aortic dissection in 2020

“…In such a scenario, the cET will always require a second operation, while FET can be prophylactic in Marfans, acute type B aortic dissection or moderately dilated descending thoracic aorta and curative in acute type A aortic dissection (ATAAD) or in rupture of an aneurysm. 3 We read the comments of Orhan Gokalp et al 4 with great interest. The authors have mentioned that sealing of entry points can happen only if "reentry tears are luckily underneath the elephant trunk stent graft."…”

“…6 The commentary has expressed concerns of what to expect in postoperative follow-up in patients with FET. 4 A study by Tsagakis et al 7 with a near 100% follow-up, comparing FET with proximal repair in ATAAD, the freedom from reintervention at 5-and 10-year favored FET significantly (87% vs. 68% and 74% vs. 48%, respectively). The other advantage of FET is that it opens the true lumen, increasing the downstream perfusion and resolving problems associated with malperfusion in ATAAD.…”

“…The other advantage of FET is that it opens the true lumen, increasing the downstream perfusion and resolving problems associated with malperfusion in ATAAD. 8 Contrary to the comment that the collared fashion of the elephant trunk graft is favorable for patients with the mega aorta, 4 the collar is fashioned in such a way that the anastomosis is efficiently performed to the aorta-usually, zone 2 aortic arches in recent times.…”