Frozen Elephant Trunk Procedure for Treatment of Acute Complicated Type B Aortic Dissections

Year 2020, Volume: 23 Issue: 1, 53 - 58, 01.04.2020

Mustafa Akbulut Adnan Ak Serpil Taş Özgür Arslan Arzu Antal Davut Çekmecelioğlu Mesut Şişmanoğlu Mehmet Tuncer

Abstract

Introduction: This study aimed to define midterm clinical outcomes and morphological changes of acute complicated type B aortic dissections after the application of frozen elephant trunk technique.

Patients and Methods: Data were collected from 143 patients treated with frozen elephant trunk procedure for complex thoracic aortic diseases between May 2012 and October 2018. Twenty-seven patients with acute complicated type B aortic dissection were included in the study.

Results: The mean age of the study population was 56.9 ± 9.1 years, and 23 (85.2%)patients were male. Complete false lumen thrombosis in the descending aorta before the distal end of the stent graft was achieved in 88.9% of cases. There was no late mortality observed at a mean follow-up of 50.7 ± 22.5 months. Only one patient died due to multiple organ failure 62 days after the operation. Five patients underwent secondary distal aortic endovascular repair because of stent graft-induced new entry (n= 3) and second-stage treatment for post-dissection aneurysm (n= 2).

Conclusion: Aortic arch involvement in acute complicated type B aortic dissections requires more extensive treatment, and frozen elephant trunk procedure serves as an alternative treatment modality.

Keywords

Aortic pathology, descending aorta, false lumen, frozen elephant trunk, type B dissection

Komplike Akut Tip B Aortik Diseksiyonların Tedavisinde Donmuş Fil Hortumu Prosedürü

Abstract

Giriş: Bu çalışma, akut komplike tip B aortik diseksiyonlarında donmuş fil hortumu tekniği uygulanmasından sonraki orta dönem klinik sonuçları ve morfolojik değişikleri tanımlamayı amaçlamıştır.

Hastalar ve Yöntem: Veriler, Mayıs 2012-Ekim 2018 tarihleri arasındaki kompleks torasik aorta hastalıkları nedeniyle donmuş fil hortumu prosedürü ile tedavi edilen 143 hastadan toplandı. Akut komplike tip B aortik diseksiyonu olan 27 hasta çalışmaya dahil edildi.

Bulgular: Çalışma popülasyonunun ortalama yaşı 56.9 ± 9.1 yıl ve 23 (%85.2) hasta erkekti. Olguların %88.9’unda stent-greft seviyesindeki inen aortada tam yalancı lümen trombozu sağlandı. Ortalama 50.7 ± 22.5 aylık takipte geç dönem mortalite gözlenmedi. Sadece bir hasta operasyondan 62 gün sonrasında çoklu organ yetmezliği nedeniyle kaybedildi. Beş hastaya stent-greft kaynaklı yeni yırtık (n= 3) ve postdiseksiyon anevrizması (n= 2) için ikinci bir distal aortik endovasküler onarım yapıldı.

Sonuç: Akut komplike tip B aortik diseksiyonlarda arkus aortanın tutulumu daha genişletilmiş bir tedavi gerektirmektedir ve donmuş fil hortumu prosedürü bu yönde hizmet eden alternatif bir yöntemdir.

Keywords

Aortic patoloji, donmuş fil hortumu, tip B aortik diseksiyon, inen aorta, yalancı lümen

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