title: Evaluation of the downstream aorta after frozen elephant trunk repair for aortic dissections in terms of diameter and false lumen status.
abstract: OBJECTIVE
  To analyse the clinical outcomes of surgical repair of DeBakey type I and III aortic dissection (AD) by using the frozen elephant trunk (FET) technique, and to evaluate the postoperative behaviour of the residual aorta.
  
  
  METHODS
  In total, 27 consecutive patients underwent treatment of the thoracic aorta for AD with the FET technique in a tertiary-care hospital in Vienna/Austria between 2005 and 2012, and were enrolled in this case series study. All operations were performed under circulatory arrest and bilateral antegrade cerebral perfusion. During the follow-up, a clinical examination was performed as well as aortic diameters and false lumen (FL) patency evaluated by computed tomography (CT) imaging at following levels: pulmonary bifurcation, diaphragm and coeliac trunk.
  
  
  RESULTS
  The mean age of the patient cohort was 56 ± 12 years; 21 patients were male. Twenty-two (82%) and 5 (18%) patients presented with DeBakey type I and type III AD, respectively. The hospital mortality rate was 7% (2/28); 2 patients died due to non-aortic-related reasons during a follow-up period of 48 ± 26 months. Three (11%) patients had a stroke, and 2 (7%) a spinal cord injury. The follow-up CT scans revealed FL thrombosis in 96% of the patients at the level of the pulmonary bifurcation (P < 0.001). Distal to the stent graft, at the level of the diaphragm and coeliac trunk, FL patency was observed in 52% (P = 0.1) and 78% (P = 0.6) of the patients, respectively. The true lumen of all analysed aortic segments increased significantly while the mean aortic diameter remained stable.
  
  
  CONCLUSIONS
  Compared with conventional surgery for extensive ADs, the FET technique provides a high rate of FL thrombosis of the thoracic aorta.
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria gabrielweiss@me.com.
authors: Gabriel
authors: G
authors: Weiss
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors: David
authors: D
authors: Santer
authors: Department of Cardiac Surgery, University Hospital Innsbruck, Innsbruck, Austria.
authors: Julia
authors: J
authors: Dumfarth
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors: Harald
authors: H
authors: Pisarik
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors: Marie Luise
authors: ML
authors: Harrer
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors: Sandra
authors: S
authors: Folkmann
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors: Markus
authors: M
authors: Mach
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors: Reinhard
authors: R
authors: Moidl
authors: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors: Martin
authors: M
authors: Grabenwoger
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001011:Aorta / Q000473:pathology*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aorta; Aortic dissection; Frozen elephant trunk technique