Сonventional and hybrid aortic arch repair for aortic dissection

Aim: To conduct comparative analysis of the early and long-term results of surgical reconstruction of the aortic arch with and without the “Frozen elephant trunk” technique in patients with aortic dissection.

Methods: A retrospective study has been conducted, 72 patients with acute and chronic aortic dissection who underwent surgical treatment were enrolled. All patients were divided into two groups. Group I (non- FET, n=17) consisted of patients who underwent conventional reconstructive surgery without using the “Frozen elephant trunk” technique. Group II (FET, n=55) included patients who underwent the “Frozen elephant trunk” procedure. A comparative analysis of early and mid-term postoperative results was carried out.

Results: In the early postoperative period in the non-FET and FET groups, the incidence of transient neurological complications was 0 vs. 3.6% (p>0.999) and cerebral stroke was 0 vs. 3.6% (p>0.999). Paraplegia was not noted in any of the groups. The need for prolonged respiratory support after surgery was recorded in 82.4% of cases in patients in the non-FET group and in 17.6% in the FET group (p<0.001). Acute kidney injury was diagnosed in 17.6% and 5.9% in the non-FET and FET groups, respectively (p=0.601). Early postoperative mortality in the non-FET group was 17.6%, in the FET group – 7.3% (p=0.344). Patient survival for 5 years after surgery was 71% in the non-FET group and 76% in the FET group. Freedom from distal aortic reintervention was 86% in the non-FET group and 100% in the FET group (p=0.861). Freedom from negative remodeling of the thoracoabdominal aorta in the non-FET and FET groups reached comparable values, not exceeding 62 and 62%, respectively (p=0.875).

Conclusion. The “Frozen elephant trunk” technique in the treatment of patients with aortic dissection is promising and characterized by satisfactory early and long-term results in this category of patients.

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