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Der Frozen-Elephant-Trunk

Indikation, Technik und Ergebnisse

Frozen elephant trunk

Indications, technique and results

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Zusammenfassung

Die Frozen-Elephant-Trunk- (FET-)Technik ist ein Hybridverfahren zwischen konventioneller und endovaskulärer Aortenchirurgie und erlaubt die Behandlung ausgeprägter Aortenbogenpathologien mit Beteiligung der Aorta descendens in einer Operation. Zudem schafft sie eine sichere Landezone für mögliche Folgeeingriffe stromabwärts. Die Indikationen für eine Behandlung mittels FET umfassen chronische Aneurysmen des distalen Bogens oder des Bogens mit Beteiligung der Aorta descendens, multisegmentale Aortenaneurysmen und akute sowie chronische Aortendissektionen. Die sog. Hybridprothese besteht aus einer klassischen Gefäßprothese für den Bogenersatz (mit Reinseration der supraaortalen Äste) und einem stenttragenden Abschnitt zur Behandlung distal gelegener Aortenabschnitte. Heutzutage ist die FET-Operation weltweit in der Aortenbogenchirurgie etabliert und wird in spezialisierten Aortenzentren routinemäßig angewendet. Der folgende Übersichtsartikel soll einen klinisch-relevanten Überblick in Bezug auf die Indikationen, operative Technik und postoperativen Ergebnisse der FET-Operation geben.

Abstract

The frozen elephant trunk (FET) technique is a hybrid procedure combining conventional and endovascular aortic surgery to allow 1‑stage treatment of the aortic arch and the proximal descending aorta. The indications for the FET operation include several aortic pathologies, such as aneurysms, acute and chronic dissections with involvement of the (distal) arch and the proximal descending aorta. The hybrid prosthesis consists of a vascular graft for transverse arch replacement with supra-aortic revascularization and a distally located stent for endovascular treatment of the descending aorta. After antegrade stent grafting of the distal aortic segment, partial or total aortic arch replacement is performed via the conventional open technique. The FET operation is nowdays routinely performed in specialized aortic centers worldwide. This article gives an overview with resoect to the clinical indications, technical aspects and postoperative results of the FET operation.

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Authors and Affiliations

  1. Herzchirurgische Klinik und Poliklinik Großhadern, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland

    M. Lühr, S. Peterß, C. Hagl &  M. Pichlmaier MA (Cantab)

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  1. M. Lühr
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  2. S. Peterß
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  3. C. Hagl
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  4. M. Pichlmaier MA (Cantab)
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Correspondence to M. Pichlmaier MA (Cantab).

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M. Lühr, S. Peterß, C. Hagl und M. Pichlmaier geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Lühr, M., Peterß, S., Hagl, C. et al. Der Frozen-Elephant-Trunk. Gefässchirurgie 21, 232–239 (2016). https://doi.org/10.1007/s00772-016-0163-5

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