Early and Long-Term Follow-Up for Chronic Type B and Type Non-A Non-B Aortic Dissection Using the Frozen Elephant Trunk Technique

Congcong Luo; Ruidong Qi; Yongliang Zhong; Suwei Chen; Hao Liu; Rutao Guo; Yipeng Ge; Lizhong Sun; Junming Zhu

doi:10.3389/fcvm.2021.714638

Early and Long-Term Follow-Up for Chronic Type B and Type Non-A Non-B Aortic Dissection Using the Frozen Elephant Trunk Technique

Front Cardiovasc Med. 2021 Sep 14:8:714638. doi: 10.3389/fcvm.2021.714638. eCollection 2021.

Authors

Congcong Luo¹, Ruidong Qi¹, Yongliang Zhong¹, Suwei Chen¹, Hao Liu¹, Rutao Guo¹, Yipeng Ge¹, Lizhong Sun¹, Junming Zhu¹

Affiliation

¹ Department of Cardiovascular Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Abstract

Background: This study aimed to evaluate the early and long-term outcomes of a single center using a frozen elephant trunk (FET) procedure for chronic type B or non-A non-B aortic dissection. Methods: From February 2009 to December 2019, 79 patients diagnosed with chronic type B or non-A non-B aortic dissection who underwent the FET procedure were included in the present study. We analyzed operation mortality and early and long-term outcomes, including complications, survival and interventions. Results: The operation mortality rate was 5.1% (4/79). Spinal cord injury occurred in 3.8% (3/79), stroke in 2.5% (2/79), and acute renal failure in 5.1% (4/79). The median follow-up time was 53 months. The overall survival rates were 96.2, 92.3, 88.0, 79.8, and 76.2% at 1/2, 1, 3, 5 and 7 years, respectively. Moreover, 79.3% of patients did not require distal aortic reintervention at 7 years. The overall survival in the subacute group was superior to that in the chronic group (P = 0.047). Conclusion: The FET technique is a safe and feasible approach for treating chronic type B and non-A non-B aortic dissection in patients who have contraindications for primary endovascular aortic repair. The technique combines the advantages of both open surgical repair and endovascular intervention, providing comparable early and long-term follow-up outcomes and freedom from reintervention.

Keywords: chronic type B aortic dissection; frozen elephant trunk technique; long term outcomes; non-A non-B aortic dissection; total arch replacement.