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Early- and medium-term results after aortic arch replacement with frozen elephant trunk techniques—a single center study

  
@article{ACS2716,
	author = {Sergey Leontyev and Martin Misfeld and Piroze Daviewala and Michael A. Borger and Christian D. Etz and Sergey Belaev and Joerg Seeburger and David Holzhey and Farhard Bakhtiary and Friedrich W. Mohr},
	title = {Early- and medium-term results after aortic arch replacement with frozen elephant trunk techniques—a single center study},
	journal = {Annals of Cardiothoracic Surgery},
	volume = {2},
	number = {5},
	year = {2013},
	keywords = {},
	abstract = {Background: The treatment of patients with extensive thoracic aortic disease involving the arch and descending thoracic/thoracoabdominal aorta is often performed using the frozen elephant trunk technique (FET). We retrospectively analyzed our results of the FET operation.
Methods: A total of 51 consecutive patients underwent total aortic arch surgery with the FET technique between January 2006 and August 2013. For all patients, the E-vita hybrid open stent-graft (Jotec, Hechingen, Germany) was used. The patients had a mean age of 64±13 years, with 51.1% being female. Degenerative or atherosclerotic aneurysm was the indication for surgery in 62.7% of patients. Another 15.7% and 13.7% suffered from acute Type A, and Type B aortic dissection, respectively.
Results: The in-hospital and 30-day mortality was 7.8%. Stroke occurred in 11.8% (n=6), and new-onset paraplegia in 19.6% (n=10) of patients. The core body temperature ≥28 ℃ during circulatory arrest, in combination with a prolonged circulatory arrest time of more than 45 minutes, was an independent predictor of permanent spinal cord injury [odds ratios (OR), 4.8; 95% confidence intervals (CI), 1.1-21; P=0.04]. The estimated 1- and 5-year survival was (80.2±5.5)% and (59.7±10.2)%, respectively, with a mean survival time of 3.4±0.4 years. The estimated mean freedom from endovascular intervention was 4.2±0.4 years. The unadjusted 1- and 5-year freedom from thoracic endovascular aortic repair (TEVAR) was (84.9±5.9)% and (69.2±11.2)%, respectively.
Conclusions: The FET procedure for extensive thoracic aortic disease is associated with an acceptable early and medium term mortality rate. This procedure is associated with a high incidence of perioperative spinal cord injury. In order to prevent the above complication, deep hypothermia is strongly recommended in patients with expected prolonged circulatory arrest time.},
	issn = {2225-319X},	url = {http://www.annalscts.com/article/view/2716}
}