Clinical Outcomes of Cuff Anastomosis Combined with Single-Branched Frozen Elephant Trunk for Acute Type A Aortic Dissection

Abstract

Background

Total arch replacement combined with the frozen elephant trunk (FET) technique has become the predominant surgical strategy for acute type A aortic dissection (ATAAD); however, reconstruction of arch vessel perfusion remains technically demanding and often results in prolonged ischemia associated with branch vessel reconstruction.

Methods

This retrospective single-center study included all patients who were diagnosed with ATAAD and underwent surgical treatment between January 2024 and June 2025. Patients were allocated to either the cuff anastomosis combined with a single-branched FET group or the control group, and baseline characteristics, intraoperative data, and short-term clinical outcomes were compared.

Results

Among the 85 enrolled patients (mean ± standard deviation age 55.00 ± 10.36 years; 17.6% female), 40 (47%) underwent cuff anastomosis combined with a single-branched FET prosthesis. Compared with controls, these patients demonstrated significantly shorter duration of surgery, aortic cross-clamp time, and circulatory arrest time (P < 0.05). They also exhibited lower incidences of acute heart failure, systemic inflammatory response syndrome, and postoperative hepatic dysfunction (P = 0.009; P = 0.013; P = 0.034).

Conclusion

In this retrospective single-center cohort, the surgical technique of cuff anastomosis combined with a single-branched FET prosthesis was associated with shorter operative duration and fewer postoperative complications, and may be a new choice for clinically effective simplification of surgical methods.