Clinical Usefulness of Hemiarch Replacement with a Total Fenestrated Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection

Matsuyama K, Watanuki H, Tochii M and Sugiyama K

Department of Cardiac Surgery, Aichi Medical University Hospital, Japan

^*Correspondance to: Katsuhiko Matsuyama 

 PDF  Full Text DOI: 10.25107/2474-1647.3730

Abstract

Background: This study aimed to compare the early results of conventional Hemiarch Replacement (HAR) and HAR with a total fenestrated Frozen Elephant Trunk (FET) technique for Acute Type a Aortic Dissection (ATAAD).
Methods: between November 2017 and January 2025, 17 patients underwent HAR with the total fenestrated FET technique (FET group) for ATAAD, and 40 patients underwent conventional HAR (HAR group). The polyester part of the FET was resected as an island at a location matching the entrance of the three arch branch vessels from outside the FET for fenestration.
Results: Operative, cardiopulmonary bypass, and aortic cross-clamp times were significantly shorter in the FET group, although circulatory arrest times were similar. An additional thoracic endovascular aortic repair was performed in 8 (20%) patients in the HAR group and in 2 (12%) patients in the FET group. The freedom from aortic events rate at the 1-year follow-up was 84% in the HAR group and 88% in the FET group. Conclusion: The HAR with FET technique significantly reduces operation time and eliminates the risk of new entry from the suture hole into the distal anastomotic site. This technique may be considered an alternative to conventional HAR in selected patients.

Keywords

Acute type A aortic dissection; Hemiarch replacement; Total arch replacement; Fenestrated frozen elephant trunk

Cite the article

Matsuyama K, Watanuki H, Tochii M, Sugiyama K. Clinical Usefulness of Hemiarch Replacement with a Total Fenestrated Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection. Clin Surg. 2025; 10: 3730..