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Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases

INTRODUCTION: The aim of this study is to compare postoperative outcomes and follow-up of two different modifications facilitating surgical technique of frozen elephant trunk (FET) procedure for complex thoracic aortic diseases - zone 0 (fixation with total arch debranching) and zone 3 (fixation wit...

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Autores principales: Akbulut, Mustafa, Ak, Adnan, Arslan, Ozgur, Dönmez, Arzu Antal, Taş, Serpil, Cekmecelioglu, Davut, Sismanoglu, Mesut, Tuncer, Mehmet Altug
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731864/
https://www.ncbi.nlm.nih.gov/pubmed/33113310
http://dx.doi.org/10.21470/1678-9741-2019-0398
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author Akbulut, Mustafa
Ak, Adnan
Arslan, Ozgur
Dönmez, Arzu Antal
Taş, Serpil
Cekmecelioglu, Davut
Sismanoglu, Mesut
Tuncer, Mehmet Altug
author_facet Akbulut, Mustafa
Ak, Adnan
Arslan, Ozgur
Dönmez, Arzu Antal
Taş, Serpil
Cekmecelioglu, Davut
Sismanoglu, Mesut
Tuncer, Mehmet Altug
author_sort Akbulut, Mustafa
collection PubMed
description INTRODUCTION: The aim of this study is to compare postoperative outcomes and follow-up of two different modifications facilitating surgical technique of frozen elephant trunk (FET) procedure for complex thoracic aortic diseases - zone 0 (fixation with total arch debranching) and zone 3 (fixation with islet-shape arch repair). METHODS: From May 2012 to December 2018, data were collected from 139 patients who had been treated with FET procedure for complex thoracic aortic diseases. According to Ishimaru arch map, patients with proximal anastomotic site of hybrid graft at zone 0 and zone 3 were grouped as Group A (n=58, 41.7%) and Group B (n=81, 58.3%), respectively. Mean age of study population was 54.7±11.4 years, and 111 patients were male (79.9%). RESULTS: In-hospital mortality was observed in 20 (14.4%) patients (n=12, acute type A aortic dissection, and n=4, previous aortic dissection surgery). There was no significant difference between both groups in terms of in-hospital mortality. Four patients from Group A and three patients from Group B had permanent neurological deficit (P=0.32). Three patients from both groups had transient spinal cord ischemia (P=0.334). Although mean total perfusion time was longer in Group A, duration of visceral ischemia, when compared with Group B, was shorter (P<0.001). Five-year survival rate was 82.8% in Group A and 81.5% in Group B (P=0.876). CONCLUSION: FET procedure is a feasible repair technique in the treatment of complex aortic diseases, providing satisfactory early results. Because of its advantageous aspects, zone 0 fixation with debranching is the preferred technique in our clinic.
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spelling pubmed-77318642020-12-16 Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases Akbulut, Mustafa Ak, Adnan Arslan, Ozgur Dönmez, Arzu Antal Taş, Serpil Cekmecelioglu, Davut Sismanoglu, Mesut Tuncer, Mehmet Altug Braz J Cardiovasc Surg Original Article INTRODUCTION: The aim of this study is to compare postoperative outcomes and follow-up of two different modifications facilitating surgical technique of frozen elephant trunk (FET) procedure for complex thoracic aortic diseases - zone 0 (fixation with total arch debranching) and zone 3 (fixation with islet-shape arch repair). METHODS: From May 2012 to December 2018, data were collected from 139 patients who had been treated with FET procedure for complex thoracic aortic diseases. According to Ishimaru arch map, patients with proximal anastomotic site of hybrid graft at zone 0 and zone 3 were grouped as Group A (n=58, 41.7%) and Group B (n=81, 58.3%), respectively. Mean age of study population was 54.7±11.4 years, and 111 patients were male (79.9%). RESULTS: In-hospital mortality was observed in 20 (14.4%) patients (n=12, acute type A aortic dissection, and n=4, previous aortic dissection surgery). There was no significant difference between both groups in terms of in-hospital mortality. Four patients from Group A and three patients from Group B had permanent neurological deficit (P=0.32). Three patients from both groups had transient spinal cord ischemia (P=0.334). Although mean total perfusion time was longer in Group A, duration of visceral ischemia, when compared with Group B, was shorter (P<0.001). Five-year survival rate was 82.8% in Group A and 81.5% in Group B (P=0.876). CONCLUSION: FET procedure is a feasible repair technique in the treatment of complex aortic diseases, providing satisfactory early results. Because of its advantageous aspects, zone 0 fixation with debranching is the preferred technique in our clinic. Sociedade Brasileira de Cirurgia Cardiovascular 2020 /pmc/articles/PMC7731864/ /pubmed/33113310 http://dx.doi.org/10.21470/1678-9741-2019-0398 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Akbulut, Mustafa
Ak, Adnan
Arslan, Ozgur
Dönmez, Arzu Antal
Taş, Serpil
Cekmecelioglu, Davut
Sismanoglu, Mesut
Tuncer, Mehmet Altug
Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases
title Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases
title_full Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases
title_fullStr Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases
title_full_unstemmed Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases
title_short Comparison between Arch Zones in Modified Frozen Elephant Trunk Procedure for Complex Thoracic Aortic Diseases
title_sort comparison between arch zones in modified frozen elephant trunk procedure for complex thoracic aortic diseases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731864/
https://www.ncbi.nlm.nih.gov/pubmed/33113310
http://dx.doi.org/10.21470/1678-9741-2019-0398
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