First-in-Human Use of the Cook Hybrid Frozen Elephant Trunk Graft: The Canadian Experience
| Autor: | François Dagenais, Vincent Chauvette, Philippe Demers, Kevin Lachapelle, Michael W.A. Chu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Aortic arch Canada medicine.medical_specialty Elephant trunks medicine.medical_treatment Aortic Diseases Aorta Thoracic 030204 cardiovascular system & hematology Anastomosis Prosthesis Design 03 medical and health sciences 0302 clinical medicine medicine.artery Freezing medicine Humans Prospective Studies Spinal cord injury Aged Aortic Aneurysm Thoracic business.industry Stent Perioperative First in human Middle Aged medicine.disease Blood Vessel Prosthesis Surgery Aortic Dissection Treatment Outcome 030228 respiratory system Cohort Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 111:1876-1882 |
| ISSN: | 0003-4975 |
| Popis: | Background Advancements in technology have changed the treatment of aortic arch pathologies. Specifically, the introduction of the frozen elephant trunk technique has allowed one-stage treatment of pathologies that would have otherwise required a two-stage procedure. We present the early outcomes of a novel frozen elephant hybrid stent graft. Methods Between August 2015 and July 2019, 39 patients (56% male; mean age 67 ± 11years) underwent an arch reconstruction with a novel hybrid stent graft in four different Canadian centers. The most common indication for surgery was arch aneurysm (31%) followed by acute dissection (28%). All patients were prospectively followed with clinical and imaging assessments. Results The device was successfully implanted in all patients. There were 3 perioperative deaths (8%). Transient spinal cord injury occurred in 5 patients (13%); all had complete neurologic recovery before discharge. Seven patients had a perioperative stroke/transient ischemic attack; 3 of them initially presented with cerebral malperfusion caused by acute dissection. One patient died during the study follow-up. Survival at 30 days and at 1 and 3 years was 92% ± 5%, 89% ± 5%, and 89% ± 5%, respectively. At a median follow-up of 16 months, 3 patients required a reintervention to address a type I distal endoleak and 1 patient was treated for a type II endoleak. There was no arch anastomosis complications. Conclusions The Cook hybrid stent graft device provides encouraging midterm results in a high-risk cohort. This novel graft is simple to deploy, may be customized to patients’ anatomy in elective cases, eases arch reconstruction, and allows versatility in the choice of arch grafts. |
| Databáze: | OpenAIRE |
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