C40 SYSTEMATIC TOTAL ARCH REPLACEMENT WITH THORAFLEX HYBRID GRAFT IN ACUTE TYPE A AORTIC DISSECTION: A SINGLE CENTRE EXPERIENCE

Autor: P Chivasso, G Mastrogiovanni, M Miele, M Colombino, D Triggiani, F Cafarelli, R Leone, P Masiello, S Iesu
Rok vydání: 2023
Předmět:
Zdroj: European Heart Journal Supplements. 25:D17-D18
ISSN: 1554-2815
1520-765X
DOI: 10.1093/eurheartjsupp/suad111.039
Popis: Introduction The traditional surgical management for acute Type A aortic dissection focuses on handling emergencies in the aortic root and ascending aorta. The remaining untreated distal portion of the aorta has a potential risk of rupture or causing malperfusion syndrome. Therefore, an aggressive repair approach using total aortic arch replacement combined with the frozen elephant trunk (FET) implantation has been advocated. We describe the early and midterm clinical outcomes of the Thoraflex Hybrid graft for the treatment of emergency type A aortic dissection. Methods Between December 2017 and January 2022, 69 consecutive patients were admitted with acute type A aortic dissection; of those, 66 patients (62.9 ± 10.2 years of age, 81.8% men) underwent emergency hybrid aortic arch and frozen elephant trunk repair with the multibranched Thoraflex hybrid graft and were enrolled in the study. Primary end point were 30 days– and in–hospital mortality. To better clarify the impact of age on surgical outcomes, we have divided the study population into two groups: group A for patients < 70 years of age (47 patients), group B for patients ≥ 70 years (19 patients). Results All 66 device implants were technically successful. Mean follow–up was 19.7 ±17.4 months. 30–days– and in–hospital mortality were 10.6 and 13.6%, respectively. Stroke occurred in 3 (4.5%) patients. Two (3.0%) patients experienced spinal cord ischemia. Renal failure requiring CVVH and respiratory failure requiring tracheostomy were 30.3% and 28.8%, respectively. Overall survival for the entire cohort at 3 months, 6 months, 12 months and 24 months was 85%, 80.3%, 76.5%, 74.4% respectively. We did not find any statistically significant difference among the two groups in terms of main post–operative outcomes. The multivariable Cox proportional hazard model showed left ventricular ejection fraction (HR: 0.83, 95% CI: 0.79–0.92, p Conclusions Hybrid aortic arch and frozen elephant trunk repair with the Thoraflex Hybrid graft to treat emergency type A aortic dissection appears to be associated with good early and mid–term clinical outcomes even in the elderly.
Databáze: OpenAIRE
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