• Roberto Di Bartolomeo, Davide Pacini, Carlo Savini, Emanuele Pilato, Sofia Martin-Suarez, Luca Di Marco, and Marco Di Eusanio.
• Cardiovascular Surgery Department, Sant'Orsola-Malpighi Hospital, Bologna University, Italy. roberto.dibartolomeo@unibo.it
• J. Thorac. Cardiovasc. Surg. 2010 Dec 1; 140 (6 Suppl): S81-5; discussion S86-91.

ObjectiveExtensive thoracic aortic aneurysms represent a challenging pathology in cardiac surgery. The frozen elephant trunk procedure, combining conventional surgery with endovascular techniques, allows single-stage treatment for such pathology. Here we present our surgical technique and results with the single-stage frozen elephant trunk procedure.MethodsBetween January 2007 and December 2009, 67 patients were treated with the frozen elephant trunk procedure in our institution. Mean age was 61 ± 11 years. Indications for surgery included chronic aneurysm (n = 22, 32.8%), acute type A dissection (n = 4, 6.0%), acute type B dissection (n = 2, 3.0%), chronic type A dissection (n = 30, 44.8%), and chronic type B dissection (n = 9, 13.4%). Thirty-six patients (53.7%) had undergone 38 previous cardiac or aortic operations. Thirty-two associated aortic and cardiac operations were performed. Brain protection was achieved by means of antegrade selective cerebral perfusion and moderate hypothermia (26°C) in all cases.ResultsIn-hospital mortality was 13.4%. Postoperatively, permanent neurologic dysfunction (coma) occurred in 5 cases (7.5%), paraplegia in 2 (3.2%), and paraparesis in 3 (4.9%). Follow-up was 100% complete, with mean duration of 11.1 ± 8.4 months. The 1- and 2-year survivals were 76.7 ± 5.6% and 70.3 ± 8.0%, respectively. Ten patients (14.9%) required endovascular completion 2.3 ± 3.1 months after the first procedure, with 100% technical and procedural success.ConclusionsIn contrast to the conventional elephant trunk technique, the frozen elephant trunk technique offers a potentially curative single-stage procedure for patients with extensive thoracic aortic disease, with encouraging short-term and midterm results.Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

40 keywords...

hide…