Long stent graft for frozen elephant trunk repair in acute type A aortic
dissection
Abstract
OBJECTIVES: The frozen elephant trunk (FET) technique has become an
important tool in the treatment of acute type A aortic dissection. The
aim of this study was to evaluate the effect of long FET on spinal cord
injury (SCI) and distal aortic remodeling after acute type A aortic
dissection based on clinical and radiological outcomes. METHODS: From
January 2018 to November 2019, 158 patients [mean age 51.8 years
(range 32 - 78 years), 88.6% male] with acute type A aortic
dissection were treated by FET with 100 mm (n=113) or 150 mm (n=45) open
hybrid stent graft prosthesis. Patients were divided into two groups
according to the length of FET. The clinical and radiological outcomes
of the patients were reviewed retrospectively. RESULTS: Postoperative
outcomes did not differ significantly: in-hospital mortality (9.7% vs
6.7%, P=0.758) and SCI (5.3% vs 2.2%, P=0.674). Aortic remodeling,
which was evaluated by aortic diameter, true lumen diameter, false lumen
diameter and the rate of false lumen complete thrombosis, was more
positive in long FET group in the descending thoracic aorta during the
follow-up period. At the abdominal level, there was no statistically
significant difference between the two groups. CONCLUSIONS: The long
version of FET does not increase the risk of SCI in patients with acute
type A aortic dissection. The application of long FET can achieve better
results in terms of remodeling of the thoracic aorta in the short- and
medium-term follow-up.