Overall Outcomes of Frozen Elephant Trunk as an Elective Procedure versus an Emergency Procedure

Objectives: The aim of this study was to compare the overall outcome of patients undergoing frozen elephant trunk (FET) as an emergency/urgent procedure versus an elective procedure.

Methods: Between October 2010 and September 2020, a total of 151 patients underwent FET procedures at our center. Of these, 51 patients (33.8%) were operated for acute aortic syndrome, 48 patients (31.8%) were operated for chronic type A or B dissection, and 52 patients (34.4%) were operated for thoracic aortic aneurysm. Outcome measures were 30-day mortality, temporary and permanent neurological deficit, paraplegia, acute kidney failure and recurrent nerve palsy. Ventilation times, ICU and in-hospital stay were also evaluated.

Result: The 30-day mortality was 4% in elective and 24% in emergency cases (p = 0.001). Temporary and permanent neurological deficit occurred in 6 and 5% in the elective versus 20 and 18% in the emergency cases, respectively (both p = 0.010). Paraplegia was 1% in elective and 8% in emergency patients (p = 0.024). Acute kidney failure occurred in 9% of elective versus 18% of emergencies cases (p = 0.001). The same tendency was observed for recurrent nerve palsy (14 vs. 20%; p = 0.001).

Ventilation time (hours) (54 ± 140 vs. 74 ± 105, p = 0.383), ICU-stay [days] (6.6 ± 8.9 vs. 8.4 ± 7.9, p = 0.228) and in-hospital stay [days] (16 ± 13 vs. 14 ± 11, p = 0.461) did not show statistical differences.

Conclusion: FET as an elective procedure is safe and associated with a good outcome. However, as an emergency procedure FET has a less favorable outcome due to the implications of the complex underlying pathologies.

Publication History

Article published online:
19 February 2021