Total arch replacement and frozen elephant trunk for acute type A aortic dissection

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• Acute Stanford type A aortic dissection presents a significant surgical challenge.
• Total aortic arch replacement is a complex procedure with associated risks.

Purpose of the Study:

• To evaluate the outcomes of total aortic arch replacement using the frozen elephant trunk technique.
• To assess the safety and efficacy of proximalizing the distal anastomosis in acute aortic dissection surgery.

Main Methods:

• Retrospective analysis of 50 patients with acute Stanford type A aortic dissection.
• Utilized the frozen elephant trunk technique with J Graft FROZENIX and Gelweave Lupiae graft.
• Distal anastomosis performed in zones 1 and 2.

Main Results:

• Overall in-hospital mortality rate was 4%.
• No cases of paraplegia or stent graft-induced new entry were observed.
• 1, 2, and 3-year survival rates were 87.9%, 84.1%, and 84.1%, respectively.

Conclusions:

• Total aortic arch replacement with the frozen elephant trunk technique (zones 1-2) is safe and effective.
• This technique simplifies surgical management for acute Stanford type A aortic dissection.
• The use of Gelweave Lupiae graft contributes to favorable outcomes.