Simplified Arch Replacement In Zone 2 Using A Branched Frozen Elephant Trunk Prosthesis
Jens Brickwedel, Lenarad Bax, Till Demal, Herman Reichenspurner, Christian Detter.
University Heart Center Hamburg, Hamburg, Germany.
Introduction: The frozen elephant trunk (FET) technique combines aortic arch replacement and descending aortic repair for aneurysm and dissection. We report our experience and the advantages of implanting the FET in arch zone 2. Methods: Between April 2013 and December 2017, 81 consecutive patients (male 60.5%, 62.7±12.9 years) underwent a FET procedure. In 19 patients the stentgraft was deployed in aortic arch zone 2 (group1) using an extra anatomical bypass to the left subclavian artery. In the remaining 62 patients stentgraft was deployed in arch zone 3 (group 2). Indications for surgery were as follows: arteriosclerotic aneurysm (35.8%, n=29), aortic dissection Debakey 1 (53.1%, n=43) and 3 (11.1%, n=9). 33.3% (n=27) were operated as an emergency for acute aortic dissection. 14 patients were diagnosed with a genetic aortic syndrome. About one quarter of the patients had previous cardiac surgery (27.2%, n=22). Results: 30-day mortality was 14.8% (n=12) and did not differ among the groups (p=0.185). Permanent neurological deficit occurred less frequently in group 1 than in group 2 (p=0.049). Procedure related times were significantly shorter for the arch zone 2: ECC 228±64min vs 285±82 min (p=0.007), aortic crossclamping time 115±39 vs 152±60 min (p=0.014), circulatory arrest time 40±10 vs 76±32 min (p=0.008), cerebral perfusion time 59±10 vs 92±33 min (p=0.000). Conclusion: Implantation of the FET in arch zone 2 reduces neurological complications and shortens procedure related times significantly.
Back to 2018 ePosters