Kuroda Taro, Tsutsumi Koji, Ishida Osamu
Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, JPN.
Cureus. 2025 Feb 7;17(2):e78664. doi: 10.7759/cureus.78664. eCollection 2025 Feb.
The favorable long-term outcomes have been reported for total arch replacement using the frozen elephant trunk technique for acute aortic dissection. However, the data on chronic degenerative aortic aneurysms treated with this technique are limited compared with those for acute aortic dissection, and the long-term outcomes are not well understood. Here, we report early and long-term outcomes of total arch replacement using the frozen elephant trunk technique in patients with chronic aortic aneurysms.
We included 37 patients with chronic degenerative aortic aneurysms who underwent total arch replacement using the frozen elephant trunk technique between January 2015 and December 2022 at the National Defense Medical College Hospital, Tokorozawa, Japan. The primary endpoints were the 30-day and five-year survival rates. The secondary endpoints were major adverse cardiac and cerebrovascular events and acute renal failure.
The 30-day mortality rate was 13.5%, and the factors influencing this rate were postoperative cerebral infarction, acute renal failure, and prolonged ventilation. The factors influencing major adverse cardiac or cerebrovascular events and acute renal failure included a history of preoperative stroke. The five-year survival rate was 61.1%.
Total arch replacement using the frozen elephant trunk technique for degenerative aortic aneurysms at our institution yielded satisfactory early and long-term surgical outcomes.
对于采用冰冻象鼻技术治疗急性主动脉夹层的全弓置换术,已有长期良好预后的报道。然而,与急性主动脉夹层相比,采用该技术治疗慢性退行性主动脉瘤的数据有限,且长期预后尚不清楚。在此,我们报告采用冰冻象鼻技术对慢性主动脉瘤患者进行全弓置换术的早期和长期预后。
我们纳入了2015年1月至2022年12月期间在日本所泽市国防医科大学医院接受冰冻象鼻技术全弓置换术的37例慢性退行性主动脉瘤患者。主要终点是30天和5年生存率。次要终点是主要不良心脑血管事件和急性肾衰竭。
30天死亡率为13.5%,影响该率的因素是术后脑梗死、急性肾衰竭和通气时间延长。影响主要不良心脑血管事件和急性肾衰竭的因素包括术前有卒中史。5年生存率为61.1%。
在我们机构,采用冰冻象鼻技术对退行性主动脉瘤进行全弓置换术取得了令人满意的早期和长期手术效果。