Frozen elephant trunk implantation in zone 0 using a left subclavian stented prosthesis

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Managing the left subclavian artery (LSA) is a complex aspect of frozen elephant trunk (FET) procedures.
• Traditional FET techniques can involve intricate LSA revascularization or debranching, increasing operative time and risk.

Purpose of the Study:

• To evaluate the feasibility and initial outcomes of a novel patient-individualized, custom-made FET hybrid prosthesis with an integrated stented LSA branch.
• To assess the potential of this new prosthesis to decrease surgical complexity in FET procedures.

Main Methods:

• Implantation of a custom-made FET hybrid prosthesis featuring a stented LSA branch in zone 0.
• Performance of an additional left internal mammary artery (LIMA) to left anterior descending (LAD) bypass concurrently.

Main Results:

• Successful implantation of the custom FET hybrid prosthesis in zone 0.
• Demonstration of a potentially simplified approach to LSA management within the FET procedure.
• Successful LIMA-to-LAD bypass performed in conjunction with the main procedure.

Conclusions:

• The patient-individualized custom FET hybrid prosthesis with a stented LSA branch offers a promising solution for simplifying complex LSA management.
• This innovative prosthesis has the potential to reduce surgical complexity and improve the safety profile of FET procedures.
• Further studies are warranted to confirm long-term efficacy and broader applicability.