Background and aim:
The Frozen Elephant Trunk (FET) is a well-known technique for the treatment of complex pathologies of the thoracic aorta. In the following years, the indications have been expanded also for chronic and acute aortic dissections. We report our experience with this technique.
Between 2007 and 2018, a total of 273 consecutive patients underwent FET procedure. Main indications were: 58.2% chronic aortic dissections (A,B and residual A), 27.1% degenerative aneurysms and 14.7% acute aortic dissections (A and B) and 52.7% were redo. Mean age of the patients was 61.34 ± 11.1 years. Baseline cardiovascular risk factors and comorbidities were analysed along with intraoperative variables, to evaluate postoperative outcome.
The overall in-hospital mortality was 16.8%, the rate of paraplegia and stroke were 3.7% and 9.2% respectively. CPB time was 229 ± 70 min and visceral ischemia time was 55 ± 20 min. ASCP time was 93.40 ± 35 min. The CPB time is a risk factor for in-hospital mortality (p-value 0.010, OR:1.011, CI: 1. 003–1.019). Follow-up was complete at 98% of the patients. Mean follow-up time was 41.6 ± 36 months and the mortality was 16.1% with a rate of reoperation of 22.4% including 43 endoprosthesis implants (19%).
The frozen elephant trunk showed satisfactory results and demonstrated to be a feasible solution for all complex pathology of thoracic aorta, in expert hands and in high volume centers. In selected cases, it allows to treat the entire thoracic aortic pathology in a single-surgical step.