Mid-term results of elective repair of extensive thoracic aortic pathology by the Evita Open Plus hybrid endoprosthesis only.
OBJECTIVE
To describe the early and mid-term clinical and instrumental results of the frozen elephant trunk (FET) procedure using the recent Evita Open Plus hybrid endoprosthesis for elective one-stage treatment of extensive thoracic aortic disease.


METHODS
We reviewed 16 patients undergoing FET for post-dissection aneurysm (50%), true aneurysm (31%) or other aetiologies (19%), through median sternotomy and hypothermic circulatory arrest. An average 14 ± 7.6-month follow-up with regular contrast-enhanced control computed tomography scans was available. Four patients received preliminary carotid-subclavian bypass to improve spinal cord protection. Distal extension through endovascular deployment of stent-grafts into the descending aorta was performed during the same procedure in 3 patients. Concomitant procedures on the ascending aorta/root were done in 25% of cases.


RESULTS
There were no cases of operative mortality. Cases of neither cerebral stroke nor postoperative paraplegia were observed. Two cases of transient paraparesis and 1 case of Brown-Séquard syndrome occurred. At follow-up, there were no cases of endoleak or endotension. One patient was reoperated for distal completion (thoracoabdominal aortic replacement).


CONCLUSIONS
The FET using the Evita Open Plus device is a reliable and versatile treatment for one-step management of extensive disease of the aortic arch and the descending aorta. This strategy should be reserved for patients having limited preoperative comorbidities and good functional status.
Department of Thoracic, Cardiac and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
Jean-Philippe
JP
Verhoye
Amedeo
A
Anselmi
Adrien
A
Kaladji
Erwan
E
Flécher
Antoine
A
Lucas
Jean-François
JF
Heautot
Xavier
X
Beneux
Olivier
O
Fouquet
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
Aortic operation; Endovascular procedures; Hybrid surgery