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Published on: June 27, 2018
Five-Year Outcomes of Hybrid Arch Frozen Elephant Trunk Repair With Novel Multibranched Hybrid Graft
Junichi Shimamura1, Rami Abazid2, Jill Gelinas1
1Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, Ontario, Canada.
Background:
The objective of this study was to report the 5-year outcomes of hybrid arch frozen elephant trunk (FET) procedures with a multibranched hybrid graft.
Methods:
Between 2014 and 2020, 50 consecutive patients (63 ± 15 years old; 34% women) underwent hybrid arch FET with Thoraflex hybrid graft (Terumo Aortic) at a single center. Indications included aortic aneurysm (n = 48 [96%]), acute aortic dissection (n = 10 [20%]), and chronic dissection (n = 20 [40%]). Follow-up was complete, and mean follow-up was 1455 ± 664 days.
Results:
All 50 patients experienced successful device implantation. The 30-day/in-hospital mortality was 2% (n = 1). Stroke and transient neurologic deficits occurred in 1 patient (2%) and 3 patients (6%). Two patients (4%) and 1 patient (2%) experienced transient and permanent spinal cord ischemia. FET thromboembolic complication was observed in 1 patient (2%). In follow-up, 6 patients died of aortic events, and there were 13 reinterventions in the downstream aorta, of which 46% (6/13) were planned second-stage operations. Survival rate at 1 year, 2 years, and 5 years was 96%, 92%, and 85%, and freedom from unplanned distal reintervention at 1 year, 2 years, and 5 years was 98%, 92%, and 81%. Computed tomography follow-up demonstrated positive distal aortic remodeling with aneurysmal regression and stabilized aortic dimensions in patients with aortic dissection.
Conclusions:
The hybrid arch FET procedure with a novel hybrid graft is associated with good early and midterm outcomes. Longer term outcomes merit further investigation.
