Open Access
CC BY 4.0 · Aorta (Stamford) 2023; 11(05): 1-18
DOI: 10.1055/s-0044-1787931
IMAD 2024 Meeting Abstracts

The Initial Experience of Frozen Elephant Trunk Operation in Ukraine

V. Kravchenko
2   M.Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
,
L. Kulyk
1   Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
,
I. Zhekov
2   M.Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
,
O. Larionova
2   M.Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
,
V. Lazoryshynets
2   M.Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
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    Background: Ongoing development of cardiovascular technologies has made it possible to carry out simultaneous replacement of the ascending, arch and descending thoracic aorta (frozen elephant trunk operation).

    Methods: From 2020 to 2024 in the National M.Amosov ICVS of the NAMS of Ukraine, operated on 797 patients with different kind of aortic pathology, 256 of them were admitted with TAAD; 55 operation of total arch replacement were performed, 25 – frozen elephant trunk operation (FET). Patients age were 36 – 68 y.o, mean – 54,2±6,4; 18 (72,0%) patients are male. Concomitant CAD had 6 (24,0%), COPD – 8 (32,0%), CRF – 5 (20,0%), DM - 5 (20,0%), pulmonary hypertension – 3 (12,0%), severe mitral insufficiency – 2 (8,0%). Three patients had right aberrant subclavian artery – a.lusoria. Twelve pts (48,0%), had cardiac operation previously. The causes of aortic injury were: acute type A aortic dissection – 1 (4,0%); chronic type A aortic dissection – 12 (48,0%), non A non B aortic dissection – 5 (20,0%), chronic type B aortic dissection – 2 (8,0%); blunt aortic injury (BAI) – 2 (8,0%), TAAA – 3 (12.0%). Simultaneously with the FET, we performed Jacoub operation – 2, CABG – 6 (1-3), MV repair – 2, TV plication – 4. All operation we profound with 25°C hypothermia and ACP for all three cerebral vessels. We used E-Vita Open Plus – 14 and E-Vita Open Neo – 11. Three operations we operated on urgently.

    Results: Hospital mortality consist 8,0% (two patient). The reasons of death were stroke and severe pulmonary insufficiency respectively. Two patients had neurological complication – permanent paraplegia and transient stroke. Renal failure needed temporary dialysis – 3. Bleeding, needed re-thoracotomy – only 1 case. Prolonged ventilation (more 2 p o days) took place in 4 pts.

    Conclusion: FET operation allowed treatment of complex patients with extensive thoracic aortic diseases with satisfactory results. Acute and chronic, especially non-A non-B type of aortic dissections represent interesting subsets for FET procedure.


     

    Die Autoren geben an, dass kein Interessenkonflikt besteht.

    Publikationsverlauf

    Artikel online veröffentlicht:
    11. Juni 2024

    © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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