Song Suk-Won, Lee Ha, Kim Myeong Su, Wong Randolph Hung Leung, Ho Jacky Yan Kit, Szeto Wilson Y, Jakob Heinz
Department of Thoracic and Cardiovascular Surgery, Ewha Womans University Aorta and Vascular Hospital, Ewha Womans University Medical Center, Seoul, Korea.
Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
J Chest Surg. 2024 Sep 5;57(5):419-429. doi: 10.5090/jcs.24.089.
The frozen elephant trunk (FET) technique can be applied to extensive aortic pathology, including lesions in the aortic arch and proximal descending thoracic aorta. FET is useful for tear-oriented surgery in dissections, managing malperfusion syndrome, and promoting positive aortic remodeling. Despite these benefits, complications such as distal stent-induced new entry and spinal cord ischemia can pose serious problems with the FET technique. To prevent these complications, careful sizing and planning of the FET are crucial. Additionally, since the FET technique involves total arch replacement, meticulous surgical skills are essential, particularly for young surgeons. In this article, we propose several techniques to simplify surgical procedures, which may lead to better outcomes for patients with extensive aortic pathology. In the era of precision medicine, the next-generation FET device could facilitate the treatment of complex aortic diseases through a patient-tailored approach.
冻结象鼻（FET）技术可应用于广泛的主动脉病变，包括主动脉弓和胸降主动脉近端的病变。FET对于夹层的撕裂导向手术、处理灌注不良综合征以及促进主动脉的正向重塑很有用。尽管有这些益处，但FET技术可能会出现诸如远端支架引起的新破口和脊髓缺血等并发症，从而带来严重问题。为预防这些并发症，对FET进行仔细的尺寸确定和规划至关重要。此外，由于FET技术涉及全弓置换，精湛的手术技巧必不可少，尤其是对于年轻外科医生而言。在本文中，我们提出了几种简化手术操作的技术，这可能会为患有广泛主动脉病变的患者带来更好的治疗效果。在精准医学时代，下一代FET装置可通过个性化方法促进复杂主动脉疾病的治疗。
