Universität zu Köln

Liakopoulos, Oliver J., Kroener, Axel, Sabashnikov, Anton, Zeriouh, Mohamed, Ahmad, Wael, Choi, Yeong-Hoon and Wahlers, Thorsten (2020). Single-center experience with the frozen elephant trunk procedure in 111 patients with complex aortic disease. J. Thorac. Dis., 12 (10). S. 5387 - 5398. SHATIN: AME PUBL CO. ISSN 2077-6624

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Abstract

Background: The frozen elephant trunk (FET) technique is increasingly used for the treatment of acute and chronic aortic arch disease. This study reports our single center experience with the FET technique in patients with complex aortic disease. Methods: Between 2009 and 2019, 111 consecutive patients underwent aortic arch surgery in our institution using the FET technique for acute type A dissection (AAD group; n=75) or non-acute type A dissection (non-AAD group; n=36; 10 patients with chronic type A dissection; 26 patients with aneurysm), respectively. Relevant perioperative data, including 30-day mortality and neurological complications, were retrospectively obtained from our electronic patients records, including follow-up (FU) data of outpatient clinical visits and computed tomography (CT). Results: Thirty-day mortality in the entire FET cohort was 16.2% (AAD 18.7% vs. non-AAD 11.1%; n=0.414). Severe brain injury was the leading cause of death in AAD patients (12.0% vs. 0% non-AAD; P=0.030). Overall permanent stroke and spinal cord injury was 12.6% and 3.6%. Four patients in the AAD group developed paraplegia and permanent stroke rate was significantly higher in AAD compared to non-AAD patients (17.3% vs. 2.8%; P=0.034). One, 3- and 5-year survival rates were 78.7%+/- 4.0%, 72.2%+/- 4.8%, and 64.3%+/- 6.8% for the total cohort; survival at 1-, 3- and 5-year was 76.7%+/- 5.0%, 71.0%+/- 6.1%, and 64.5%+/- 8.3% for the AAD cohort compared to 83.1%+/- 6.3%, 75.0%+/- 7.9% and 66.7% for non-AAD patients (P=0.579), respectively. Conclusions: Our single-center experience confirms good early and mid-term survival after the FET procedure in patients presenting with AAD, CAD and aneurysm. Future efforts should focus on reduction of severe neurological complication.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroener, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Ahmad, Wael UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-316073
DOI:	10.21037/jtd-20-1531
Journal or Publication Title:	J. Thorac. Dis.
Volume:	12
Number:	10
Page Range:	S. 5387 - 5398
Date:	2020
Publisher:	AME PUBL CO
Place of Publication:	SHATIN
ISSN:	2077-6624
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ARCH REPLACEMENT; PROSTHESIS; REPAIR Multiple languages Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31607