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. 2020 Dec 1;35(6):934-941.
doi: 10.21470/1678-9741-2019-0398.

Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases

Mustafa Akbulut  1 , Adnan Ak  1 , Ozgur Arslan  1 , Arzu Antal Dönmez  1 , Serpil Taş  1 , Davut Cekmecelioglu  1 , Mesut Sismanoglu  1 , Mehmet Altug Tuncer  1
Affiliations

Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases

Mustafa Akbulut et al. Braz J Cardiovasc Surg. .

Abstract

Introduction: The aim of this study is to compare postoperative outcomes and follow-up of two different modifications facilitating surgical technique of frozen elephant trunk (FET) procedure for complex thoracic aortic diseases - zone 0 (fixation with total arch debranching) and zone 3 (fixation with islet-shape arch repair).

Methods: From May 2012 to December 2018, data were collected from 139 patients who had been treated with FET procedure for complex thoracic aortic diseases. According to Ishimaru arch map, patients with proximal anastomotic site of hybrid graft at zone 0 and zone 3 were grouped as Group A (n=58, 41.7%) and Group B (n=81, 58.3%), respectively. Mean age of study population was 54.7±11.4 years, and 111 patients were male (79.9%).

Results: In-hospital mortality was observed in 20 (14.4%) patients (n=12, acute type A aortic dissection, and n=4, previous aortic dissection surgery). There was no significant difference between both groups in terms of in-hospital mortality. Four patients from Group A and three patients from Group B had permanent neurological deficit (P=0.32). Three patients from both groups had transient spinal cord ischemia (P=0.334). Although mean total perfusion time was longer in Group A, duration of visceral ischemia, when compared with Group B, was shorter (P<0.001). Five-year survival rate was 82.8% in Group A and 81.5% in Group B (P=0.876).

Conclusion: FET procedure is a feasible repair technique in the treatment of complex aortic diseases, providing satisfactory early results. Because of its advantageous aspects, zone 0 fixation with debranching is the preferred technique in our clinic.

Keywords: Aneurysm, Dissecting; Aorta; Aortic Diseases; Blood Vessel Prosthesis Implantation; Follow-Up Studies; Hospital Mortality; Spinal Cord Ischemia; Survival Rate.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1
Fig. 1
Preoperative (A) and postoperative (B) computerized tomography angiography images of frozen elephant trunk modification; zone 0, fixation with total arch de-branching.
Fig. 2
Fig. 2
Preoperative (A) and postoperative (B) computerized tomography angiography images of frozen elephant trunk modification; zone 3, fixation with islet-shape arch repair.
See this image and copyright information in PMC

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