Patologia estesa dell'aorta toracica: Trattamento ibrido con la tecnica del frozen elephant trunk

Translated title of the contribution: Extensive disease of the thoracic aorta: Hybrid treatment with the frozen elephant trunk technique

Marco Di Eusanio, Alessandro Armaro, Luca Di Marco, Davide Pacini, Antonio Pantaleo, Roberto Di Bartolomeo

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. Aneurysms of the aortic arch extending beyond the origin of the left subclavian artery represent a challenging pathology in aortic surgery and, most commonly, are treated with different surgical, endovascular or hybrid two-staged procedures. In 2006, we initiated an intense surgical program with the frozen elephant trunk procedure that, combining together conventional surgery with endovascular techniques, allows single-stage treatment of patients with extended disease of the thoracic aorta. We here describe our surgical technique and the results with the single-stage frozen elephant trunk procedure. Methods. Between January 2007 and August 2010, 87 patients were treated with the frozen elephant trunk procedure in our institution. The mean age was 62 ± 10 years. Indications for surgery included: chronic aneurysm (n=28; 32.2%), acute type A dissection (n=5; 5.7%), acute type B dissection (n=2; 2.3%), chronic type A dissection (n=41; 47.2%), chronic type B dissection (n=11; 12.6%). Forty-nine patients (56.4%) had undergone previous cardiac/aortic operations. Sixty-four associated aortic/cardiac operations were performed. Results. Hospital mortality was 12.6%. Postoperatively, major neurological complications occurred in 4 patients (4.5%) and paraplegia in 6 (6.9%). Follow-up was 100% completed at a mean time of 15.0 ± 12.4 months. Estimated 3-year survival was 72.7 ± 8.3%. Endovascular extension was required in 14 patients (16.0%) with a technical/procedural success of 100%. Conclusions. Our preliminary results with the frozen elephant trunk in the above-mentioned high-risk group of patients were encouraging. The frozen elephant trunk, as a single-stage hybrid procedure, avoids peculiar drawbacks of staged procedures such as cumulative mortality of two major aortic procedures, interval mortality and failure to complete the final stage.

Original languageItalian
Pages (from-to)434-438
Number of pages5
JournalGiornale Italiano di Cardiologia
Volume12
Issue number6
DOIs
Publication statusPublished - Jun 2011

Fingerprint

Thoracic Aorta
Dissection
Therapeutics
Aneurysm
Endovascular Procedures
Subclavian Artery
Mortality
Paraplegia
Hospital Mortality
Pathology
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Patologia estesa dell'aorta toracica : Trattamento ibrido con la tecnica del frozen elephant trunk. / Di Eusanio, Marco; Armaro, Alessandro; Di Marco, Luca; Pacini, Davide; Pantaleo, Antonio; Di Bartolomeo, Roberto.

In: Giornale Italiano di Cardiologia, Vol. 12, No. 6, 06.2011, p. 434-438.

Research output: Contribution to journalArticle

Di Eusanio, Marco ; Armaro, Alessandro ; Di Marco, Luca ; Pacini, Davide ; Pantaleo, Antonio ; Di Bartolomeo, Roberto. / Patologia estesa dell'aorta toracica : Trattamento ibrido con la tecnica del frozen elephant trunk. In: Giornale Italiano di Cardiologia. 2011 ; Vol. 12, No. 6. pp. 434-438.
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abstract = "Background. Aneurysms of the aortic arch extending beyond the origin of the left subclavian artery represent a challenging pathology in aortic surgery and, most commonly, are treated with different surgical, endovascular or hybrid two-staged procedures. In 2006, we initiated an intense surgical program with the frozen elephant trunk procedure that, combining together conventional surgery with endovascular techniques, allows single-stage treatment of patients with extended disease of the thoracic aorta. We here describe our surgical technique and the results with the single-stage frozen elephant trunk procedure. Methods. Between January 2007 and August 2010, 87 patients were treated with the frozen elephant trunk procedure in our institution. The mean age was 62 ± 10 years. Indications for surgery included: chronic aneurysm (n=28; 32.2{\%}), acute type A dissection (n=5; 5.7{\%}), acute type B dissection (n=2; 2.3{\%}), chronic type A dissection (n=41; 47.2{\%}), chronic type B dissection (n=11; 12.6{\%}). Forty-nine patients (56.4{\%}) had undergone previous cardiac/aortic operations. Sixty-four associated aortic/cardiac operations were performed. Results. Hospital mortality was 12.6{\%}. Postoperatively, major neurological complications occurred in 4 patients (4.5{\%}) and paraplegia in 6 (6.9{\%}). Follow-up was 100{\%} completed at a mean time of 15.0 ± 12.4 months. Estimated 3-year survival was 72.7 ± 8.3{\%}. Endovascular extension was required in 14 patients (16.0{\%}) with a technical/procedural success of 100{\%}. Conclusions. Our preliminary results with the frozen elephant trunk in the above-mentioned high-risk group of patients were encouraging. The frozen elephant trunk, as a single-stage hybrid procedure, avoids peculiar drawbacks of staged procedures such as cumulative mortality of two major aortic procedures, interval mortality and failure to complete the final stage.",
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