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International Society For Minimally Invasive Cardiothoracic Surgery

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Mini FET Procedure In Patient With Debakey Type I Aortic Dissection
Eduard Charchyan, Denis Breshenkov, Yuriy Belov
Petrovsky Russian Research Centre of Surgery, Moscow, Russian Federation

BACKGROUND: Minimally invasive frozen elephant trunk (FET) through J-shaped ministernotomy (MS) is now done rarely. Although some consider that mini-FET have severe limitations, some studies showed certain advantages of the minimally invasive approach. Also, in current literature, there is no common technique, so we present our technique of mini-FET.
METHODS: We present a step-by-step technique of performing mini-FET and Bentall procedures using the J-shaped MS. A 61-years-old M presented with chronic DeBakey type I aortic dissection and aneurysm of ascending aorta and aortic root. This video showcases the tips and tricks of how to gain exposure of distal anastomosis, the technique of supra-aortic branches reimplantation and stenting of distal descending thoracic aorta using a hybrid stent-graft.
RESULTS: Accurate patient selection and detailed preoperative planning can provide a safe FET procedure with results comparable to the conventional approach and also provide faster recovery.
CONCLUSIONS: Mini-FET is a safe, effective and reproducible procedure with comparable results with the conventional approach. Certain tips and tricks help with providing optimal exposure and technical difficulty that is no different than full sternotomy.


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