Usefulness of frozen elephant trunk technique for distal aortic arch aneurysms

Abstract

Aim: The effectual use of frozen elephant trunk (FET) has been for total aortic arch replacement (TAR) of acute aortic dissection because of positive aortic remodeling. However, the use of FET in the non-dissecting aortic arch aneurysm is still contr oversial. We aim to investigate the outcomes of TAR using the FET technique for distal aortic arch aneurysms.

Methods: Between August 2014 and February 2020, 40 patients (35 males, mean age 77.0 years) underwent TAR by using the FET technique with the J Graft Open Stent Graft for distal aortic arch aneurysms including 8 patients with shaggy aorta. In 5 of 40 patients, coronary bypass grafting was concomitantly performed. We followed up for 29.0 months.

Results: The mortality were 0%. Stroke occurred in three patients (7.5%) one of whom had shaggy aorta, paraparesis in one patient (2.5%) who recovered fully, and respiratory complication in two patients (5.0%). There was no recurrent nerve palsy. During the follow-up period, death had no relationship with aortic disease.

Conclusion: We conclude the FET has the potential to improve TAR for distal aortic arch aneurysms.

Keywords

Aortic arch aneurysm / frozen elephant trunk / open stent / left recurrent nerve palsy / shaggy / total aortic arch replacement

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