Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Apr;94(16):e694.
doi: 10.1097/MD.0000000000000694.

Outcome of frozen elephant trunk technique for acute type A aortic dissection: as systematic review and meta-analysis

Affiliations
Meta-Analysis

Outcome of frozen elephant trunk technique for acute type A aortic dissection: as systematic review and meta-analysis

Hui-Han Lin et al. Medicine (Baltimore). 2015 Apr.

Abstract

Acute aortic dissections of Stanford type A require emergency surgery repair and present challenges to surgeons. The frozen elephant technique is one of several approaches used to treat aortic arch dissection. The purpose of this meta-analysis was to investigate the clinical effectiveness of the frozen elephant technique for treating acute type A aortic dissection.Medline, Cochrane, Google Scholar, and ClinicalTrials.gov databases were searched up to March 31, 2014, for studies that assessed the use of frozen elephant trunk technique for treating acute type A aortic dissection. The primary outcome was in-hospital mortality. Secondary outcomes included rate of stroke, spinal cord injury, renal failure, and reoperations for bleeding.Eleven studies were included in the analysis that encompassed 881 patients. The mean age ranged from 45.4 to 66.8 years, and the proportion of the population that was male ranged from 45 to 85%. The overall in-hospital mortality rate was 8%. The rate of stroke, spinal cord injury, renal failure, and frequency of reoperations for bleeding were 3, 4, 5, and 5, respectively. Sensitivity analysis indicates that the findings are robust and there was no publication bias.These findings indicate that the frozen elephant techniques does not bring unacceptable mortality or morbidity risk for treating acute type A aortic dissection.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Flowchart of study selection.
FIGURE 2
FIGURE 2
Meta-analysis for (A) in-hospital mortality, (B) stroke, (C) spinal cord injury, (D) renal failure, and (E) reoperation for bleeding.
FIGURE 3
FIGURE 3
Sensitivity analysis for in-hospital mortality.
FIGURE 4
FIGURE 4
Funnel plot for publication bias for in-hospital mortality.

References

    1. Wiesenfarth JM. Acute Aortic Dissection. http://emedicine.medscape.com/article/756835-overview Accessed October 6, 2014.
    1. Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. J Am Coll Cardiol 2010; 55:e27–e129. - PubMed
    1. Sun L, Qi R, Zhu J, et al. Total arch replacement combined with stented elephant trunk implantation: a new “standard” therapy for type a dissection involving repair of the aortic arch? Circulation 2011; 123:971–978. - PubMed
    1. Jakob H, Tsagakis K, Pacini D, et al. The International E-vita Open Registry: data sets of 274 patients. J Cardiovasc Surg 2011; 52:717–723. - PubMed
    1. Borst HG, Walterbusch G, Schaps D. Extensive aortic replacement using “elephant trunk” prosthesis. Thorac Cardiovasc Surg 1983; 31:37–40. - PubMed

MeSH terms