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Impact of Modified Frozen Elephant Trunk Procedure on Downstream Aorta Remodeling in Acute Aortic Dissection: CT Scan Follow-Up

Koechlin, Luca and Kaufmann, Josefin and Macius, Evelina and Bremerich, Jens and Sommer, Gregor and Gahl, Brigitta and Schurr, Ulrich and Grapow, Martin and Reuthebuch, Oliver and Eckstein, Friedrich and Berdajs, Denis A.. (2020) Impact of Modified Frozen Elephant Trunk Procedure on Downstream Aorta Remodeling in Acute Aortic Dissection: CT Scan Follow-Up. World Journal of Surgery, 44 (5). pp. 1648-1657.

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Abstract

The aim was to evaluate the impact of a modified frozen elephant trunk procedure (mFET) on remodeling of the downstream aorta following acute aortic dissections.; Over a period of 8 years, 205 patients (mean age 62.6 ± 12.6 years) underwent a mFET (n = 69, 33.7%) or isolated ascending aorta replacement (n = 136, 66.3%) (iAoA). Aortic diameter was assessed at the aortic arch (AoA), at the mid of the thoracic aorta (mThA), at the thoracoabdominal transition (ThAbd) and at the celiac trunk level (AbdA).; Mean follow-up was 3.3 ± 2.6 years. In-hospital mortality was 14% (n = 28), 7% in mFET and 17% in the iAoA group (p = 0.08). At the end of the follow-up, overall survival was 84% (95% CI 70-92%) and 75% (65-82%) and freedom from aorta-related reoperation was 100% and 95% (88-98%) for mFET and iAoA, respectively. At iAoA, the average difference in diameter change per year between mFET and iAoA was for total lumen 0 mm (- 0.95 to 0.94 mm, p = 0.99), and for true lumen, it was 1.23 mm (- 0.09 to 2.55 mm) per year, p = 0.067. False lumen demonstrated a decrease in diameter in mFET as compared to iAoA by - 1.43 mm (- 2.75 to - 0.11 mm), p = 0.034. In mFET, at the aortic arch level the total lumen diameter decreased from 30.7 ± 4.8 mm to 30.1 ± 2.5 mm (Δr + 2.90 ± 3.64 mm) and in iAoA it increased from 31.8 ± 4.9 to 34.6 ± 5.9 mm (Δr + 2.88 ± 4.18 mm).; The mFET procedure provides satisfactory clinical outcome at short term and mid-term and has a positive impact on aorta remodeling, especially at the level of the aortic arch.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Innere Organe > Herzchirurgie (Eckstein)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Innere Organe > Herzchirurgie (Eckstein)
UniBasel Contributors:Koechlin, Luca and Schurr, Ulrich and Grapow, Martin T.R. and Reuthebuch, Oliver and Eckstein, Friedrich Stefan and Berdajs, Denis
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Springer
ISSN:0364-2313
e-ISSN:1432-2323
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:31 Mar 2022 12:26
Deposited On:31 Mar 2022 12:26

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