Sustained Long-Term Results with Minimal Reintervention Rates in Patients with Frozen Elephant Trunk and Acute Aortic Syndromes.

Abstract

The Frozen Elephant Trunk (FET) technique is indicated in acute aortic syndromes with arch involvement and malperfusion of tissues. We sought to report on long-term outcomes of FET in emergent cases of acute aortic syndromes. Methods: Twenty-three adult patients were referred to our department for surgical management of acute aortic syndromes and underwent aortic arch replacement using the FET technique between November 2010 and January 2022. The primary outcome was long-term survival. Secondary outcomes were the 30-day mortality rate and the incidence of neurologic complications, i.e., stroke and spinal cord ischemia. Results: The mean patient age was 57.1 (±12.5) years, and the majority (20 patients, 87%) were male. The most common indication was Stanford type A acute aortic dissection (aTAAD) in 17 (74%) patients, followed by non-A non-B dissection in 2 (8.7%) patients, penetrating aortic ulcer (PAU) of the aortic arch in 2 (8.7%) patients, type A intramural hematoma (IMH) in 1 (4.3%) patient and blunt thoracic aortic injury of the aortic arch in 1 (4.3%) patient. Kaplan-Meier survival analysis revealed a 73% survival at 12 months, which persisted up to 11 years of follow-up. Conclusion: The FET technique provides a reliable solution for surgical management of patients with acute aortic syndromes. Excellent, sustained long-term results can be achieved.