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Updated: Aug 29, 2025
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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
456
Total arch replacement versus proximal aortic replacement in acute type A aortic dissection: Aggressive versus
Matti Jubouri1, Daniyal Matin Ansari2, Feras Zaqout3
1Hull York Medical School, University of York, York, UK.
Journal of Cardiac Surgery
|September 10, 2022
Summary
Total arch replacement (TAR) with the frozen elephant trunk (FET) technique offers superior outcomes for acute type A aortic dissection (ATAAD) compared to proximal aortic replacement (PAR). This approach improves long-term survival and reduces reoperation rates in ATAAD patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Disease Management
Background:
- Acute type A aortic dissection (ATAAD) is a critical condition with high mortality, escalating with delayed intervention.
- Surgical repair of ATAAD involves debated techniques, primarily proximal aortic replacement (PAR) versus total arch replacement (TAR).
Purpose of the Study:
- To evaluate the comparative effectiveness of aggressive (TAR) versus conservative (PAR) surgical strategies for ATAAD.
- To analyze pooled individual patient data from studies comparing TAR and PAR in ATAAD management.
Main Methods:
- Comprehensive literature search across major electronic databases (PubMed, Ovid, Google Scholar, EMBASE, Scopus).
- Pooled analysis of Kaplan-Meier-derived individual patient data from relevant studies.
Main Results:
- The total arch replacement (TAR) approach demonstrated more favorable outcomes in ATAAD patients.
- TAR was associated with improved long-term survival and a reduced need for reoperation.
- The frozen elephant trunk (FET) technique is identified as the primary TAR method.
Conclusions:
- Total arch replacement (TAR) with the frozen elephant trunk (FET) technique is the superior strategy for managing ATAAD.
- This approach offers better long-term survival and fewer reoperations for ATAAD patients.
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