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Long-term results of the frozen elephant trunk technique in primary chronic type B aortic dissection.
Ito, Hisato; Bessho, Saki; Shomura, Yu; Kato, Noriyuki; Kanemitsu, Shinji; Mizumoto, Toru; Hirano, Koji; Maze, Yasumi; Tokui, Toshiya; Takao, Motoshi.
Afiliación
  • Ito H; Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan. hisato.ito@gmail.com.
  • Bessho S; Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
  • Shomura Y; Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
  • Kato N; Department of Radiology, Mie University Hospital, Tsu, Mie, Japan.
  • Kanemitsu S; Department of Cardiothoracic Surgery, Anjo Kosei Hospital, Anjo, Aichi, Japan.
  • Mizumoto T; Department of Cardiothoracic Surgery, Anjo Kosei Hospital, Anjo, Aichi, Japan.
  • Hirano K; Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan.
  • Maze Y; Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan.
  • Tokui T; Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan.
  • Takao M; Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
Gen Thorac Cardiovasc Surg ; 72(12): 770-778, 2024 Dec.
Article en En | MEDLINE | ID: mdl-38822182
ABSTRACT

OBJECTIVES:

The aim of this study is to analyze long-term results of the total aortic arch replacement with the frozen elephant trunk technique for primary chronic type B aortic dissection.

METHODS:

Among 322 patients who had the frozen elephant trunk technique, 43 (13.4%) patients (median age, 64.0 years) with primary chronic type B aortic dissection were analyzed. The patients underwent surgery at a median of 27.0 months after the onset of aortic dissection. The false lumen was patent in 30 (69.8%) patients preoperatively.

RESULTS:

Two patients suffered paraplegia and another died of cerebral infarction. Complete thrombosis of the peri-stent false lumen was achieved in 36 (83.7%) patients. Overall survival, freedom from aortic events, and freedom from aortic reintervention were 83.5%, 37.2%, and 42.2% at 5 years, respectively. Survival rates of the patients with or without aortic events were 75.0% and 95.8% at 5 years (Log-rank, p = 0.22). Late aortic events occurred in 19 (44.2%) patients including distal stent graft-induced new entry, type Ib endoleak, and false lumen dilation. The ratio of the stent graft diameter to the preoperative short axis diameter of the true lumen (hazard ratio, 1.90; 95% confidence interval, 1.01-3.59), and the maximal diameter of a postdissection aneurysm (1.07; 1.01-1.12) were the significant multivariate risk predictors of late aortic events.

CONCLUSIONS:

Late aortic events occurr fairly frequently, and new strategies need to be explored to enhance the effectiveness of this procedure in the future.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Stents / Aneurisma de la Aorta Torácica / Implantación de Prótesis Vascular / Procedimientos Endovasculares / Disección Aórtica Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Gen Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Stents / Aneurisma de la Aorta Torácica / Implantación de Prótesis Vascular / Procedimientos Endovasculares / Disección Aórtica Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Gen Thorac Cardiovasc Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón