Key result
Total arch replacement using a frozen elephant trunk for acute exacerbation of type B aortic dissection significantly reduced false lumen diameter from 16.4 mm to 5.9 mm, with 0% early mortality and no spinal cord injuries.
Why the study?
The timing and choice of surgical method for type B aortic dissection remain a topic of much debate.
Does total arch replacement using frozen elephant trunk (TAR-FET) prevent distant aortic events and improve survival in patients with acute type B aortic dissection requiring surgery?
Cohort (n=142)
No
Does total arch replacement using frozen elephant trunk (TAR-FET) prevent distant aortic events and improve survival in patients with acute type B aortic dissection requiring surgery?
Total arch replacement using frozen elephant trunk (TAR-FET) is a viable and safe surgical strategy for type B aortic dissection, yielding excellent 5-year event-free survival without severe complications like RTAD or paraplegia.
Answers are grounded in this paper and cite their sources.
May support selective TAR-FET in complicated type B dissection; leaves open need for randomized trials versus TEVAR.
The timing and choice of surgical method for type B aortic dissection, is still a topic of much debate. We performed total arch replacement using frozen elephant trunk (TAR-FET) as a means of preventing distant aortic events, such as retrograde type A aortic dissection (RTAD). We conducted analysis of 142 patients with acute type B dissection who were admitted between January of 2010 and July of 2017. Fifty-five cases required surgical intervention to treat enlargement of the false lumen diameter and ULP formation 2 weeks after the onset of symptoms. 17 TAR-FET were performed with a mean of 42±26 days period from onset to surgery. There were no complications of RTAD or paraplegic, and 90% of patient demonstrated aortic event free survival (5 years) and false lumen reduction ratio of 35%. Based on our analysis, using TAR-FET properly avoids serious complications like RTAD, and is a viable treatment option for type B dissection. (This is a translation of J Jpn Coll Angiol 2018; 58: 151-157.).
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Matsuzaki et al. (2019) conducted a cohort in Acute type B aortic dissection (n=142). Total arch replacement using frozen elephant trunk (TAR-FET) vs. Preoperative baseline was evaluated on False lumen diameter (mm) (p=<0.001). Total arch replacement using a frozen elephant trunk for acute exacerbation of type B aortic dissection significantly reduced false lumen diameter from 16.4 mm to 5.9 mm, with 0% early mortality and no spinal cord injuries.
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