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Conventional and frozen elephant trunk surgery for extensive aneurysmal disease of the thoracic aorta: a retrospective comparative study Marco Di Eusanio.

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Presentation on theme: "Conventional and frozen elephant trunk surgery for extensive aneurysmal disease of the thoracic aorta: a retrospective comparative study Marco Di Eusanio."— Presentation transcript:

1 Conventional and frozen elephant trunk surgery for extensive aneurysmal disease of the thoracic aorta: a retrospective comparative study Marco Di Eusanio 1, Michael A. Borger 2, Francesco D. Petridis 1, Sergei Leontyev 2, Antonio Pantaleo 1, Monica Moz 2, Friedrich W. Mohr 2 and Roberto Di Bartolomeo 1 1 Departments of Cardiac Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy 2 Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany

2 Different surgical and hybrid procedures are available to treat patients with extensive disease of the thoracic aorta. No comparative studies exist comparing short- and mid- term outcomes after extensive aneurysm repair using the Conventional Elephant Trunk (ET) and the Frozen Elephant Trunk (FET) procedures. Here we report our experience BACKGROUND

3 Extensive aneurysms of thoracic aorta n=57 FET n=21 ET n=36 Exclusion criteria: aortic dissection descending thoracic aorta < 40 mm thoraco-abdominal aneurysm method of brain protection other then antegrade selective brain perfusion STUDY POPULATION

4 Patients’ characteristics. ET (n=36)FET (n=21) n(%) p Age64.36± ± Gender (female)17(47.2%)3(14.3%)0.011 COPD4(11.1%)5(23.8%)0.185 Renal Failure3(8.3%) Cad6(37.5%) Diabetes3(8.3%)3(14.3%)0.387 Smoking6(40%) Hypertension12(75%)13(76.5%)0.619 Cerebral Vasculopaty3(8.3%)3(14.3%)0.387 Redo4(11.1%)6(28.6%)0.096

5 Surgical techniques ET (n=36)FET (n=21) n(%) p Arterial cannulation Femoral10(27.8%)1(4.8%) Axillary20(55.6%)10(47.6%) Ascending Ao2(5.6%)4(19.0%) Femoral/Axillary4(11.1%)2(9.5%) Brachiocefalic Trunk-3(14.3%) Others-1(4.8%) Arch vessel reimplantation Island23(63.9%)11(52.4%) Separated graft13(36.1%)8(38.1%) none-2(9.5%)

6 Surgical techniques (continued) ET (n=36)FET (n=21) n(%) p Associated procedures20(55.6%)5(23.8%)0.019 MV repair2(5.6%)- AV repair5(13.9%)- AV replacement6(16.7%)4(19.0%) CABG8(22.2%)1(4.8%) Bentall3(8.3%)- Aortic valve reimplantation5(13.9%)- CPB time (min)202.03± ± Aortic X-clamp time (min)118.31± ± ASCP time (min)45.28± ± Visceral ischemia time (min)62.40± ±

7 Hospital outcomes ET (n=36)FET (n=21) n(%) p Hospital death5/36(13.9%)1/21(4.8%)0.272 Stroke-coma2/35(5.7%)2/21(9.5%)0.483 Paraplegia1/35(2.9%)1/21(4.8%)0.614 Ventilatory support>3 days 7/36(19.4%)4/21(19%)0.628 Dialysis2/36(5.6%)2/21(9.5%)0.471 Bleeding5/36(13.9%)1/21(4.8%)0.272

8 1y2yy3yy4yy ET survival (%) pts at risk (n) FET survival (%) pts at risk (n)12533 Log Rank= 0.816

9 CONCLUSION In patients with extensive aneurysms of the thoracic aorta ET and FET procedures were associated with similar satisfactory short- and mid- term outcomes. Longer-term follow up are warranted


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