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Frozen Elephant Trunk for Aortic Dissection Using Different Hybrid Grafts: Preliminary Results from a Prospective
Boris Kozlov1, Dmitri Panfilov1, Vitaliy Lukinov2
1Cardiology Research Institute-Branch of the Federal State Budgetary Scientific Institution 'Tomsk National Research Medical Center of the Russian Academy of Sciences', 634012 Tomsk, Russia.
Journal of Personalized Medicine
|May 27, 2023
Summary
This study found no significant differences in early outcomes between MedEng and E-vita OP hybrid grafts for frozen elephant trunk repair in aortic dissection. Mid-term survival showed a trend favoring the MedEng graft, though not statistically significant.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- The frozen elephant trunk (FET) technique is increasingly used for aortic dissection, with various hybrid grafts available.
- Different hybrid grafts may have distinct features impacting surgical outcomes.
- Comparing outcomes of different FET hybrid grafts is crucial for optimizing patient care.
Purpose of the Study:
- To compare early- and mid-term outcomes of FET repair for aortic dissection using two different hybrid grafts: MedEng and E-vita open plus (E-vita OP).
Main Methods:
- A prospective randomized study of 45 patients with acute/chronic aortic dissections (Type A and B).
- Patients were assigned to receive either the E-vita OP graft (n=19) or the MedEng graft (n=26).
- Primary endpoint was early- and mid-term mortality; secondary endpoints included postoperative complications like stroke, spinal cord ischemia, and renal injury.
Main Results:
- No statistically significant differences in early mortality or major complications (stroke, spinal cord ischemia, respiratory failure, acute kidney injury, re-operation) were observed between the MedEng and E-vita OP groups.
- Early mortality rates were 8% for MedEng and 0% for E-vita OP (p=0.501).
- Mid-term survival was 79% for MedEng and 61% for E-vita OP (p=0.079), indicating a non-significant trend favoring the MedEng graft.
Conclusions:
- Both MedEng and E-vita OP hybrid grafts demonstrate comparable early outcomes in FET repair for aortic dissection.
- While not statistically significant, a trend towards improved mid-term survival was noted with the MedEng graft.
- Further research may be warranted to confirm the potential mid-term benefits of the MedEng graft.
