United Kingdom Results of Ascending Aorta, Arch Replacement with Concomitant Open Descending Aorta Stenting Using a Hybrid Stent-graft, Frozen Elephant Trunk Technique, for Acute Type A Dissection
- #AC/AOR 01-O-3
- Adult Cardiac Surgery/Aortic. SESSION-1
- Oral
United Kingdom Results of Ascending Aorta, Arch Replacement with Concomitant Open Descending Aorta Stenting Using a Hybrid Stent-graft, Frozen Elephant Trunk Technique, for Acute Type A Dissection
Hassan Kattach 1, George Asimakopoulos 2, Haris Bilal 3, Pedro Catarino 4, Vamsidhar Dronavalli 5, John Dunning 4, Manoj Kuduvalli 6, James Kuo 7, Jorge Mascaro 5, Giovanni Mariscalco 8, Gavin Murphy 8, Aung Oo 6, Cesare Quarto 2, Jonathan Unsworth-White 7, Geoffrey Tsang 1
1 University Hospital Southampton, Southampton, United Kingdom; 2 Royal Brompton and Harefield NHS foundation Trust, London, United Kingdom; 3 Manchester Heart Centre, Manchester, United Kingdom; 4 Papworth Hospital NHS foundation Trust, Cambridge, United Kingdom; 5 University Hospital Birmingham, Birmingham, United Kingdom; 6 Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom; 7 Derriford Hospital, Plymouth Hospitals NHS Trust, Plymouth, Plymouth, United Kingdom; 8 University Hospitals of Leicester NHS Trust, Leicester, United Kingdom;
Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–B
Abstract
Objectives
The Frozen Elephant Trunk (FET) technique in acute Type A dissection (ATAAD) may be useful technically and in preventing long term complications. Non-selective national outcomes have not been reported. We report the UK results.
Methods
Between 2013 and 2017, data were collected and analysed prospectively from UK patients who underwent the FET technique in ATAAD.
Results
There were 66 patients (39 males). Mean age 62±12 years. 26% presented with collapse or malperfusion. 5% had previous cardiac surgery, 80% normal LV function, 25% connective tissue disorder, 58% hypertension, 22% diabetes and 11% COPD.
Mean stent size was 30mm (range 24-38mm). Mean cardiopulmonary bypass, myocardial ischaemia, distal body ischaemia and selective antegrade cerebral perfusion times were 338±104, 197±72, 79±33 and 77±31 minutes respectively. 47%had concomitant cardiac procedures.
8 (12%) died in hospital, 11 (17%) developed permanent or temporary neurological deficit. There was no paraplegia or paraparesis. The mean ITU and hospital stays were 10.7±10.3 days and 22.8±14.7 days. One died during follow up(mean follow up 16±12 months, range 1-55 months, survival 86.6%) and 4 (7%) required further distal aorta endovascular intervention.
Conclusion
In non-selected UK centres, it is possible to perform the FET technique in ATAAD with acceptable results.