Literature DB >> 19231387

Operative strategy for acute type a aortic dissection: ascending aortic or hemiarch versus total arch replacement with frozen elephant trunk.

Naomichi Uchida1, Hidenori Shibamura, Akira Katayama, Norimitsu Shimada, Miwa Sutoh, Hiroshi Ishihara.   

Abstract

BACKGROUND: This report compares long-term results with total arch replacement with frozen elephant trunk (FET) to ascending aortic or hemiarch replacement (AHR) for acute type A aortic dissection.
METHODS: The subjects were 120 consecutive patients, including 65 who received FET and 55 who had AHR for acute type A aortic dissection from 1997 to 2008. The late results after surgery were retrospectively compared between the FET and ARH groups.
RESULTS: Three patients in the FET group died, and 2 patients in the AHR group died. In long-term follow-up (mean, 67 months), the survival rate after 5 years was 95.3% for the FET group and 69.0% for the AHR group (p = 0.03). The event rate for the thoracic aorta after 5 years showed a significant difference between the FET and AHR groups (95.7% versus 73.0%, p = 0.01). A false lumen at the proximal descending aorta was patent in 16 patients (29%) in the AHR group, but it was thrombosed in all in the FET group.
CONCLUSIONS: In patients with acute type A aortic dissection, it is possible to perform extensive primary repair using the FET technique with relative safety. FET may reduce the necessity for further operations to manage a residual false lumen.

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Year:  2009        PMID: 19231387     DOI: 10.1016/j.athoracsur.2008.11.061

Source DB:  PubMed          Journal:  Ann Thorac Surg        ISSN: 0003-4975            Impact factor:   4.330


  23 in total

1.  Should the dissected aortic arch be replaced in acute type A dissection? The Mayo Clinic perspective.

Authors:  Sebastian A Iturra; Alberto Pochettino
Journal:  Ann Cardiothorac Surg       Date:  2013-03

2.  Influence of operative strategy for the aortic arch in DeBakey type I aortic dissection - analysis of the German Registry for Acute Aortic Dissection type A (GERAADA).

Authors:  Jerry Easo; Ernst Weigang; Philipp P F Hölzl; Michael Horst; Isabell Hoffmann; Maria Blettner; Otto E Dapunt
Journal:  Ann Cardiothorac Surg       Date:  2013-03

3.  Type A aortic dissection: the extent of surgical intervention.

Authors:  Martin Grabenwoger; Gabriel Weiss
Journal:  Ann Cardiothorac Surg       Date:  2013-03

4.  [German Registry for Acute Aortic Dissection Type A (GERAADA): initial results].

Authors:  L O Conzelmann; T Krüger; I Hoffmann; B Rylski; J Easo; M Oezkur; K Kallenbach; O Dapunt; M Karck; E Weigang
Journal:  Herz       Date:  2011-09       Impact factor: 1.443

5.  Long-term outcomes of tear-oriented ascending/hemiarch replacements for acute type A aortic dissection.

Authors:  Kei Aizawa; Koji Kawahito; Yoshio Misawa
Journal:  Gen Thorac Cardiovasc Surg       Date:  2016-04-08

6.  Total Arch versus Hemiarch Replacement for Type A Acute Aortic Dissection: A Single-Center Experience.

Authors:  Antonio Lio; Francesca Nicolò; Emanuele Bovio; Andrea Serrao; Jacob Zeitani; Antonio Scafuri; Luigi Chiariello; Giovanni Ruvolo
Journal:  Tex Heart Inst J       Date:  2016-12-01

Review 7.  How should we manage type A aortic dissection?

Authors:  Arminder S Jassar; Thoralf M Sundt
Journal:  Gen Thorac Cardiovasc Surg       Date:  2018-06-20

8.  Best surgical option for arch extension of type B aortic dissection: the open approach.

Authors:  Joon Bum Kim; Thoralf M Sundt
Journal:  Ann Cardiothorac Surg       Date:  2014-07

9.  Re-interventions on the thoracic and thoracoabdominal aorta in patients with Marfan syndrome.

Authors:  Florian S Schoenhoff; Thierry P Carrel
Journal:  Ann Cardiothorac Surg       Date:  2017-11

10.  Multibranched Frozen Elephant Trunk with Left Subclavian Artery Cannulation.

Authors:  Gian Luca Martinelli; Alessandro Vivacqua; Maurizio Braccio; Attilio Cotroneo; Pierpaolo Greco; Mauro Cassese
Journal:  Aorta (Stamford)       Date:  2014-04-01
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