Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi Chuoku, Kobeshi, Hyogoken, 650-0047, Japan.
Surg Today. 2022 Feb;52(2):324-329. doi: 10.1007/s00595-021-02337-y. Epub 2021 Jul 19.
The frozen elephant-trunk (FET) procedure is used widely in total aortic arch replacement (TAR) surgery; however, its safety, effectiveness, and long-term outcomes compared with those of the conventional elephant trunk (cET) procedure for degenerative aneurysms are unclear.
Between July, 2011 and August, 2019, 126 patients underwent elective total aortic arch replacement at our institution. We compared the short- and mid-term outcomes of 60 patients who underwent the FET procedure (FET group) with those of 66 patients who underwent cET (cET group).
The in-hospital mortality rate tended to be lower in the FET group than in the cET group (p = 0.12). There were two cases of paraplegia (3.3%) in the FET group and in none in the cET group. The all-cause mortality at the 3-year follow-up did not differ significantly between the groups (p = 0.31). The FET group required more unexpected interventions at the surgical site in the mid-term period.
FET was associated with a shorter operative time and lower surgical mortality than cET. Although the mid-term total aortic arch replacement outcomes of FET were acceptable, careful imaging observation is necessary because reinterventions were required more frequently.
冰冻象鼻（FET）技术广泛应用于全主动脉弓置换术（TAR）中；然而，对于退行性动脉瘤，其与传统象鼻（cET）技术相比的安全性、有效性和长期结果尚不清楚。
2011 年 7 月至 2019 年 8 月，我院对 126 例患者进行了择期全主动脉弓置换术。我们比较了 60 例行 FET 术（FET 组）与 66 例行 cET 术（cET 组）患者的短期和中期结果。
FET 组的院内死亡率低于 cET 组（p=0.12）。FET 组有 2 例（3.3%）截瘫，cET 组无截瘫。3 年随访时两组全因死亡率无显著差异（p=0.31）。FET 组在中期需要更多的意外手术部位干预。
与 cET 相比，FET 具有更短的手术时间和更低的手术死亡率。尽管 FET 的中期全主动脉弓置换术结果可接受，但需要更仔细的影像学观察，因为需要更频繁地进行再次干预。
