Abstract
Objective: This study compared the results of the conventional Frozen Elephant Trunk (FET) technique with those of a new approach for the treatment of Acute Aortic Dissection (AAD).
Summary background data: Frozen Elephant Trunk has revolutionized the treatment of extensive aortic pathologies. Hypothermic circulatory arrest is a recommendation for its implementation but remains the greatest burden. Our approach for the FET (Simplified Delivery-FET) procedure allows distal suturing in normothermia with a shorter circulatory arrest time.
Methods: This was a non-randomized, multicenter, retrospective study of all patients who underwent total arch replacement for AAD using either the normothermia (SD-FET) or conventional FET (control) techniques. The primary endpoints were in-hospital mortality, stroke, and spinal cord injury.
Results: One hundred and fifty-three patients were included (n=90 SD-FET; n=63 control FET). Overall, in-hospital mortality was 13.3% (n=20), 10.3% (n=9) in the SD-FET group and 27.5% (n=11) in the control FET group ( P =0.206). There were no differences in the rates of postoperative stroke and spinal cord injury. SD-FET was protective for combined outcome (death and/or neurological event) with a corresponding population-average percentage of events of 17.8% (5.3-27.7) in the SD-FET group versus 30.7% (16.5-52.8) in the FET group. The Kaplan-Meier showed a survival rate at 12 and 24 months of 87% in the SD-FET group versus 83% in the FET group and 86% in the SD-FET group versus 80% FET ( P =0.625), respectively.
Conclusions: The SD-FET technique allows hybrid arch surgery to be performed without cooling and is associated with a lower incidence of the combined criteria of death and/or neurological events.
Publication Date
9-30-2025
Content Type
article
PubMed ID:
Citation
Guimbretière G, Vallée A, David CH, Foucher Y, Kermen S, Fouquet O, Eid M, Schoell T, Gonthier S, Celmeta B, Bourguignon T, Guihaire J, Roussel JC, Braunberger E, Bonnet N, Ghoreishi M, Sénage T. A Frozen Elephant Trunk Technique to Reduce Circulatory Arrest Time in Hybrid Aortic Arch for Acute Aortic Dissection: Early and Midterm Outcomes in a Multicentric Cohort of 153 Patients. Ann Surg. 2025 Sep 30. doi: 10.1097/SLA.0000000000006933. Epub ahead of print. PMID: 41026522.