Sustained Long-Term Results with Minimal Reintervention Rates in Patients with Frozen Elephant Trunk and Acute Aortic...

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Acute aortic syndromes (AAS) with aortic arch involvement present complex surgical challenges.
• The Frozen Elephant Trunk (FET) technique is a key intervention for these critical conditions.
• Evaluating long-term outcomes of FET in emergent AAS cases is crucial for clinical practice.

Purpose of the Study:

• To report on the long-term survival and complication rates associated with the FET technique in emergent acute aortic syndromes.
• To assess the efficacy and safety of FET for aortic arch replacement in a cohort of adult patients.

Main Methods:

• A retrospective analysis of 23 adult patients undergoing aortic arch replacement with FET for emergent AAS between November 2010 and January 2022.
• Primary outcome: long-term survival. Secondary outcomes: 30-day mortality, stroke, and spinal cord ischemia incidence.
• Kaplan-Meier survival analysis was used to evaluate long-term outcomes.

Main Results:

• The study included 23 patients (mean age 57.1 years, 87% male).
• Stanford type A acute aortic dissection was the most frequent indication (74%).
• Kaplan-Meier analysis showed 73% survival at 12 months, sustained up to 11 years.

Conclusions:

• The Frozen Elephant Trunk technique is a reliable surgical solution for managing acute aortic syndromes involving the aortic arch.
• Excellent and sustained long-term results are achievable with the FET technique in emergent cases.
• FET provides a safe and effective option for complex aortic arch pathology.