title: Long-term results of simplified frozen elephant trunk technique in complicated acute type A aortic dissection: A case-control study.
abstract: OBJECTIVE
  To describe the long-term experience of a simplified frozen elephant trunk technique (sFETT) used in complicated acute type A aortic dissection (AAAD) treatment.
  
  
  RESULTS
  Between January 2001 and December 2012, 34 patients (mean age 59.9 ± 11.0 years) with complicated AAAD (DeBakey I) underwent an emergency surgery including sFETT. sFETT consisted in gluing the dissected aortic arch wall layers with gelatine-resorcinol adhesive and video-assisted antegrade open arch aortic stent-graft deployment in the arch or proximal descending aorta. In addition to sFETT, the aortic root was addressed with standard techniques. A 30-day mortality was 14.7% (five patients) due to bleeding (1), multiple organ failure (2), and colon ischemia (2). Postoperative morbidity included neurological (2), renal (1) and cardio-pulmonary complications (4), as well as wound infection (1). Mean follow-up was 74.4 ± 45.0 months. Actual survival rates were 73.5% at 1 year, 70.2% at 5 years, and 58.5% at 13 years of follow-up. Six patients died during long-term follow-up from heart failure (1) and unknown reasons (5). Five patients required reoperation for aortic arch (3) or aorto-iliac (2) progression of aneurysm during the mid- and long-term follow-up. The remaining patients showed favorable evolution of the dissected aorta with false lumen occlusion in most cases and stable aortic diameters.
  
  
  CONCLUSIONS
  In AAAD patients, sFETT as used in our series is an easy and safe technique to repair the aortic arch. Long-term results after sFETT showed false lumen occlusion and stable aortic diameter in up to 13 years of follow-up.
authors.affiliation: Kawaminami Hospital, Kawaminami Koyu Miyazaki, Japan.
authors.forename: Misato
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Clinic for Cardiovascular Surgery, Zurich University Hospital, Zurich, Switzerland lyubov.chaykovska@usz.ch.
authors.forename: Lyubov
authors.initials: L
authors.lastname: Chaykovska
authors.affiliation: Clinic of Cardiology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Bernd
authors.initials: B
authors.lastname: van der Loo
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Thi Dan Linh
authors.initials: TD
authors.lastname: Nguyen
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Puippe
authors.affiliation: Clinic for Cardiovascular Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Sacha
authors.initials: S
authors.lastname: Salzberg
authors.affiliation: Chiba University Hospital Department of Cardiovascular Surgery, Inohana Chuo-ku Chiba, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueda
authors.affiliation: Clinic for Cardiovascular Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.affiliation: Vascular Surgery Unit, University Hospital 'P. Giaccone', Palermo, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Pecoraro
authors.affiliation: Clinic for Cardiovascular Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Lachat
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D000072226:Computed Tomography Angiography; D004630:Emergencies; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D020535:Video-Assisted Surgery
chemical_list: D014014:Tissue Adhesives
keywords: Complicated acute type A aortic dissection; frozen elephant trunk