Total aortic arch replacement using elephant trunk or frozen elephant trunk technique: a case-control matching study.

Area of Science:

• Cardiovascular Surgery
• Thoracic Aortic Surgery
• Aortic Arch Disease Management

Background:

• Surgical management of aortic arch diseases presents significant challenges in cardiovascular surgery.
• This study compares the outcomes of the frozen elephant trunk (FET) technique versus the conventional elephant trunk (ET) technique.

Purpose of the Study:

• To compare the clinical outcomes between FET and conventional ET techniques for aortic arch replacement.
• To evaluate short- and mid-term results in patients undergoing these procedures.

Main Methods:

• A case-control matched analysis of 70 patients who underwent aortic arch replacement between 2001 and 2017.
• 25 patient pairs were matched for age, sex, acute aortic dissection, and need for concomitant procedures.
• Comparison of in-hospital mortality, stroke, renal failure, bleeding, ICU stay, and survival rates.

Main Results:

• In-hospital mortality was similar between FET (20%) and ET (32%) groups (P=0.52).
• Incidence of stroke, acute renal failure, postoperative bleeding, and ICU length of stay were comparable.
• One-year survival rates were higher in the FET cohort (60%) compared to ET (38%), but this difference was not statistically significant.

Conclusions:

• Both conventional ET and FET procedures demonstrate acceptable mid-term outcomes for extensive aneurysmal aortic disease.
• Slight differences were observed in short- and mid-term outcomes between the two techniques.