Document Detail


The frozen elephant trunk technique for treatment of thoracic aortic aneurysms.
MedLine Citation:
PMID:  17257934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The frozen elephant trunk technique allows for single-stage repair of combined aortic arch and descending aortic aneurysms using a hybrid prosthesis with a stented and a nonstented end. This report summarizes the operative and follow-up data (mean follow-up: 20 months) with this new treatment. METHODS: Between September 2001 and March 2006, 39 patients (15 women; mean age, 62 years) were operated on after approval by the local Institutional Review Board. Indications for operation were aneurysms in 18 patients and aortic dissections in 21. The stented end of the hybrid prosthesis was placed through the opened aortic arch under fluoroscopic control using hypothermic circulatory arrest and selective antegrade cerebral perfusion. RESULTS: All patients survived the procedure. Five patients (12.8%) died early postoperatively, with two deaths directly related to the procedure. Symptoms of neurologic dysfunction developed in 5 patients and resolved completely in 2. In 1 patient, the descending aorta was perforated owing to misplacement of the stented end of the hybrid prosthesis. In 23 of 25 patients with postoperative computed tomography imaging (>6 months postoperatively), complete thrombus formation around the frozen elephant trunk was observed. CONCLUSIONS: This procedure is performed through a median sternotomy and combines the concepts of the elephant trunk principle and endovascular stenting of descending aortic aneurysms. Favorable intraoperative and postoperative results in the follow-up with thrombus formation around the stented descending aortic segment has encouraged us to evaluate all patients with thoracic aneurysms extending proximal and distal of the left subclavian artery for this treatment.
Authors:
Hassina Baraki; Christian Hagl; Narwid Khaladj; Klaus Kallenbach; Jürgen Weidemann; Axel Haverich; Matthias Karck
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  S819-23; discussion S824-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany. hassinabaraki@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aorta*
Aorta, Thoracic / injuries,  surgery*
Aortic Aneurysm, Thoracic / surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  methods*,  mortality
Equipment Design
Female
Follow-Up Studies
Humans
Male
Middle Aged
Nervous System Diseases / etiology
Stents*
Sternum / surgery
Thrombosis / etiology,  radiography
Tomography, X-Ray Computed
Treatment Outcome
Wounds, Penetrating / etiology

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


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