Skip to main content
SpringerLink
Log in

The long-term outcomes of partial arch repair using the frozen elephant trunk technique for distal arch aortic aneurysm

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate the long-term results of partial arch repair using the frozen elephant trunk (FET) technique for distal arch aortic aneurysm and to examine the late complications.

Methods

Thirty-eight patients with true distal arch aortic aneurysms were repaired with FET introduced through an incision in the proximal arch aorta. Follow-up computed tomography was performed every 6 or 12 months in 36 surviving patients. The maximum dimension of the excluded aneurysmal space was measured to determine whether the aneurysmal space had decreased or disappeared. Late complications were also evaluated during the long-term follow-up.

Results

There was 1 hospital death (2.6%) and 1 (2.6%) case of paraplegia. There were 2 late sudden deaths (5.2%) thought to be due to aneurysm rupture and arrhythmia. Postoperative serial-computed tomography showed shrinkage of the excluded aneurysmal space in 33 of 36 patients. Late aneurysmal formation occurred in the anastomotic site in three patients. One patient underwent thoracic endovascular stent grafting 10 years after surgery, 1 patient had total arch replacement 9 years after surgery, and 1 died due to rupture.

Conclusion

Frozen elephant trunk was found to be a useful alternative for treating true distal arch aortic aneurysm. However, we must be alert for late aneurysmal formation at the incision site.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Mitchell RS, Dake MD, Semba CP, Fogarty TJ, Zarins CK, Liddel RP, et al. Endovascular stent-grafting repair of thoracic aortic aneurysm. J Thorac Cardiovasc Surg. 1996;111:1054–62.

    Article  CAS  Google Scholar 

  2. Dake MD, Miller DC, Semb CP, Mitchell RS, Walker PJ, Liddell RP. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med. 1994;23:1729–34.

    Article  Google Scholar 

  3. Slonim MD, Nyman U, Semba CP, Miller CD, Mitchell RS, Dake MD. Aortic dissection: percutaneous management of ischemic complications with endovascular stents and balloon fenestration. J Vasc Surg. 1996;23:241–53.

    Article  CAS  Google Scholar 

  4. Kato M, Ohnishi K, Kaneko M, Ueda T, Kishi D, Mizushima T, et al. New graft-implanting method for thoracic aortic aneurysm or dissection with a stent-graft. Circulation. 1996;94(Suppl):II188–93.

    CAS  PubMed  Google Scholar 

  5. Uchida N, Katayama A, Higashiue S, Shiono M, Hara M, Minami K, et al. A new device as an open stent graft for extended aortic repair: a multicenter early experience in Japan. Eur J Cardiothorac Surg. 2016;49:1270–8.

    Article  Google Scholar 

  6. Verhoye JP, Beihaj Soulami R, Fourquet O, Ruggiieri VG, Kaladji A, Tomasi J, et al. Elective frozen elephant trunk procedure using the E-Vita Open Plus prosthesis in 94 patients: a multicentre French registry. Eur J Cardiothorac Surg. 2017;52:733–9.

    Article  Google Scholar 

  7. Sueda T, Watarai M, Okada K, Orihashi K, Matsuura Y. Endovascular stent-grafting through the aortic arch: an alternative approach for distal arch aortic aneurysm. Ann Thorac Surg. 2000;70:1251–4.

    Article  CAS  Google Scholar 

  8. Orihashi K, Matsuura Y, Sueda T, Watari M, Okada K, Sugawara Y, et al. Echocardiography-assisted surgery in transaortic endovascular stent grafting. Role of transesophageal echocardiography. J Thorac Cardiovasc Surg. 2000;120:672–8.

    Article  CAS  Google Scholar 

  9. DiBartolomao R, Pacimi D, Savini C, Pilato E, Martin-Suarez S, Di Marco L, et al. Complex thoracic aortic disease: single-stage procedure with the frozen elephant trunk technique. J Thorac Cardiovasc Surg 2010;40:S81–5 (discussion S86–91).

    Article  Google Scholar 

  10. Kato M, Matsuda T, Kaneko M, Kuratani T, Mizushima T, Seo Y, et al. Outcomes of stent-graft treatment of false lumen in aortic dissection. Circulation 1998;98(19 Suppl):II305–11 (discussion II311–2).

    CAS  PubMed  Google Scholar 

  11. Usui A, Fujimoto K, Ishiguchi T, Yoshikawa M, Akita T, Ueda Y. Cerebrospinal dysfunction after endovascular stent-grafting via a median sternotomy: the frozen elephant trunk procedure. Ann thorac Surg. 2002;74:1821-4.

    Article  Google Scholar 

  12. Sueda T, Takahashi S. Spinal cord injury as a complication of thoracic endovascular aneurysmal repair. Surg Today. 2018;48:473–77.

    Article  Google Scholar 

  13. Katayama K, Uchida N, Katayama A, Takahashi S, Takasaki T, Kurosaki T, et al. Multiple factors predict the risk of spinal cord injury after the frozen elephant trunk technique for extended thoracic aortic disease. Eur J Cardiothorac Surg. 2015;47:616–20.

    Article  Google Scholar 

  14. Watarai M, Sueda T, Ishii O, Imai K, Shibamura H, Sakai H, et al. Shrinkage of excluded aneurysmal space: the excellent results of endovascular stent grafting through the aortic arch for distal arch aneurysm. J Thorac Cardiovasc Surg. 2001;122:829–32.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Graduate School of Medicine, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Taijiro Sueda, Shinya Takahashi, Keijiro Katayama, Shohei Morita, Masazumi Watanabe & Tatsuya Kurosaki

Authors
  1. Taijiro Sueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shinya Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keijiro Katayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shohei Morita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masazumi Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tatsuya Kurosaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Taijiro Sueda.

Ethics declarations

Conflict of interest

Taijiro Sueda and the other co-authors have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sueda, T., Takahashi, S., Katayama, K. et al. The long-term outcomes of partial arch repair using the frozen elephant trunk technique for distal arch aortic aneurysm. Surg Today 48, 1035–1039 (2018). https://doi.org/10.1007/s00595-018-1688-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-018-1688-x

Keywords

Search

Navigation