Mid-term Outcomes of Frozen Elephant Trunk for Chronic Aortic Dissection.

BACKGROUND

The aim of the study was to analyse the mid-term outcomes of the frozen elephant trunk (FET) procedure for chronic aortic dissection (СAD).

METHODS

From March 2012 to December 2022, 123 FET procedures were performed in patients with acute and chronic aortic dissection (CAD) as well as aortic aneurysm. Fifty-eight patients with CAD were eligible for study. CAD patients were divided into 2 groups: type A (n = 32) and type B (n = 26). Pre-, intra-, and postoperative data were collected retrospectively from electronic patient records, with a median follow-up period of 21.5 months (range 1-96 months).

RESULTS

The overall 30-day mortality in CAD patients was 10.3%. The overall survival rate for the entire cohort was 66.5 ± 7.9%, and for type A and type B patients, respectively, it was 77.6 ± 8.1% and 53 ± 1.3% (P = 0.229). Distal stent graft-induced new entry developed in 2 (3.4%) patients. Freedom from composite outcome (death or/and distal aortic re-intervention) for the entire cohort was 56.8 ± 9.8%, and for type A and type B patients was 66.5 ± 1.2% and 44.8 ± 1.4%, respectively (P = 0.181). The incidence of stroke was 1.7%. Two patients (3.4%) had signs of spinal cord ischemia. Respiratory failure occurred in 14 patients (23.1%). The rate of dialysis was 15.5% (n = 9). The chest re-exploration for bleeding rate was 5.2% (n = 3).

CONCLUSIONS

Early and late outcomes (death and/or distal aortic re-intervention) after the FET in CAD are tolerable without difference between type A and type B.