Mid-term outcomes of frozen elephant trunk for chronic aortic dissection

Background: The aim of the study was to analyze the mid-term outcomes of the frozen elephant trunk (FET) procedure for chronic aortic dissection (СAD).

Methods: From March 2012 to December 2022, 123 FET procedures were performed in patients with acute and chronic aortic dissection as well as aortic aneurysm. Fifty-five patients with chronic aortic dissection (CAD) were eligible for study. CAD patients were divided into 2 groups: type A (n=32), type B (n=26). Pre-, intra- and postoperative data were collected retrospectively from electronic patient records, with median follow-up period of 21.5 months (range, 1-96).

Results: The overall 30-day mortality in CAD patients was 10.3%. The overall survival rate for the entire cohort was 66.5±7.9%, for type A and type B patients was 77.6±8.1% and 53±1.3%, respectively (P = 0.229). Distal stent-graft-induced new entry developed in 2 (3.4%) patients. Freedom from composite outcome (death or/and distal aortic re-intervention) for the entire cohort was 56.8±9.8%, and for type A and type B patients was 66.5±1.2% and 44.8±1.4%, respectively (P = 0.181). The incidence of stroke was 1.7%. Two (3.4%) patients had signs of SCI. Respiratory failure occurred in 14 (23.1%) patients. The rate of dialysis was 15.5% (n=9). The chest re-exploration for bleeding rate was 5.2% (n=3).

Conclusions: Early and late outcomes (death or/and distal aortic re-intervention) after the FET in CAD are tolerable without difference between type A and type B.