Related Experiment Video
Updated: Oct 5, 2025
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
519
Risk factors for stroke after total aortic arch replacement using the frozen elephant trunk technique.
Tim Berger1, Maximilian Kreibich1, Felix Mueller1
1Department of Cardiovascular Surgery, Faculty of Medicine, University Heart Centre, University Hospital Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
Interactive Cardiovascular and Thoracic Surgery
|January 29, 2022
Summary
Postoperative stroke after frozen elephant trunk repair is a significant risk, often embolic. Advanced organ protection and monitoring are crucial, especially for elderly patients with neurological deficits or bovine arch anatomy.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Vascular Medicine
Background:
- Total aortic arch replacement using the frozen elephant trunk technique is a complex procedure.
- Postoperative stroke is a known complication, impacting patient outcomes.
Purpose of the Study:
- To analyze risk factors for postoperative stroke.
- To evaluate the mechanisms of stroke.
- To report on outcomes of patients experiencing stroke after this procedure.
Main Methods:
- Retrospective analysis of 250 patients undergoing total aortic arch replacement with frozen elephant trunk.
- Interdisciplinary evaluation of postoperative strokes by cardiac surgeons, neurologists, and radiologists.
- Logistic regression analysis to identify stroke predictors.
Main Results:
- The incidence of symptomatic postoperative stroke was 16.8%, with 13.6% being disabling.
- Embolism was the primary mechanism (73.8%).
- Predictors for stroke included age >75, bovine arch, and acute preoperative neurological deficit.
Conclusions:
- Postoperative stroke following frozen elephant trunk repair remains a challenge, predominantly embolic.
- Improved organ protection and monitoring are essential.
- Particular attention should be paid to high-risk patients (elderly, preoperative neurological deficit, bovine arch).
Related Concept Videos
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
43
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
43
01:22Aneurysm IV: Nursing Management
33
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
33
01:30Aneurysm I: Introduction
37
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
37
01:26Aneurysm III: Interprofessional Care
45
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
45