Fenestrated and covered frozen elephant trunk technique for management of chronic aortic dissection

Reintervention for residual dissection after repaired type A aortic dissection remains challenging. When a frozen elephant trunk (FET) is used, the incidence of distal stent graft-induced new entry (d-SINE) is reportedly high in chronic dissection.

We report a case of successful redo arch repair using fenestrated and covered FET techniques for chronic residual aortic dissection.

After the arch was transected proximal to the left subclavian artery (LSCA), and a modified FET prosthesis, in which the distal edge of the FET was covered, was deployed. A fenestration was created in the FET on the LSCA aspect.

The postoperative course was uneventful.

The distal edge of the FET was covered to prevent d-SINE. Creation of a fenestration on the FET eliminates the need to reconstruct the LSCA.

The fenestrated FET technique simplifies redo arch repair and the covered FET technique can potentially prevent d-SINE.