Document Detail


The frozen elephant trunk technique for the treatment of extensive thoracic aortic aneurysms: operative results and follow-up.
MedLine Citation:
PMID:  15922612     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The 'frozen' elephant trunk technique allows for single-stage repair of combined aortic arch and descending aortic aneurysms using a 'hybridprosthesis' with a stented and a non-stented end. This report summarizes the operative- and follow-up data (mean follow-up 14 months) with this new treatment. METHODS: Between 09/01 and 4/04, 22 patients (62+/-9 years; 9 female) with different aortic pathologies (15 aortic dissections, 7 aneurysms) were operated on after approval from the local institutional review board. The stented end of the hybridprosthesis was deployed in the descending aorta through the opened aortic arch during hypothermic circulatory arrest and selective antegrade cerebral perfusion. RESULTS: All patients survived the procedure but one patient died of acute hemorrhage due to rupture of the false lumen in the descending aorta on the second postoperative day. Two patients required reexploration of the chest for bleeding complications. In 2 of 4 patients who developed neurological dysfunction, symptoms resolved completely. In one of them, the descending aorta was perforated intraoperatively due to misplacement of the stented end of the hybridprosthesis. In all follow-up CT-scans thrombus formation in the descending aortic aneurysm excluded by the stented end of the hybridprosthesis has been observed. CONCLUSIONS: This procedure is performed through median sternotomy and combines the concepts of the elephant trunk operation and endovascular stenting of descending aortic aneurysms. Favourable intraoperative and postoperative results during follow-up with regard to thrombus formation around the stented descending aortic segment encourage us to evaluate all patients with thoracic aneurysms extending to proximal and distal of the left subclavian artery for this treatment.
Authors:
Matthias Karck; Ajay Chavan; Nawid Khaladj; Holger Friedrich; Christian Hagl; Axel Haverich
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  28     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-25     Completed Date:  2005-11-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  286-90; discussion 290     Citation Subset:  IM    
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, 30623 Hannover, Germany. karck@thg.mh-hannover.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm, Dissecting / surgery
Aortic Aneurysm, Thoracic / radiography,  surgery*
Cardiopulmonary Bypass / methods
Female
Heart Valve Prosthesis Implantation / methods*
Humans
Male
Middle Aged
Postoperative Hemorrhage / surgery
Prosthesis Design
Reoperation
Thrombosis / etiology
Time Factors
Tomography, X-Ray Computed / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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