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The modified frozen elephant trunk may outperform limited and extended-classic repair in acute type I dissection by Eric E Roselli; Benjamin Kramer; Emidio Germano; Andrew Toth; Patrick R Vargo; Faisal Bakaeen; Venu Menon; Eugene H Blackstone; Marc Gillinov; Gosta Pettersson; Edward Soltesz; Lars G Svensson; Daniel Burns; Kevin Hodges; Marijan Koprivanac; Francis Caputo; Sean Lyden; Levester Kirksey; Jon Quatromoni; Ali Khalifeh; Milind Desai; Vidyasagar Kalahasti; Brian Griffin; Richard Grimm; Paul Cremer; Bo Xu; Donald Hammer; Jay Ramchand; Maran Thamilarasan; Neha Quatromoni; Penelope Rampersad; Christine Jellis; Paul Schoenhagen; Michael Bolen; Christina Rigelsky; John Apostalakis; Andrew Bauer; Collaborators from Cleveland Clinic Aorta Center is a Medicine article available to read on EtoBox.

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Abstract Objectives A better surgical approach for acute DeBakey Type 1 dissection has been sought for decades. We compare operative trends, complications, reinterventions, and survival after limited vs extended-classic vs modified frozen elephant trunk (mFET) repair for this condition. Methods From 1/1/1978 to 1/1/2018, 879 patients underwent surgery for acute DeBakey Type I dissection at Cleveland Clinic. Repairs were limited to the ascending aorta/hemi-arch (701,79%) or extended through the arch (extended-classic [88,10%] or mFET [90,10%]). Weighted propensity score matching established comparable groups. Results Among weighted propensity-matched patients, mFET repair had similar circulatory arrest times and postoperative complications to limited repair, except for postoperative renal failure, which was twice as high in the limited group (25% [n = 19] vs 12% [n = 9], P = 0.006). Lower in-hospital mortality was observed following limited compared to extended-classic repair (9.1% [n = 7] vs.19% [n = 16], P = 0.03), but not after mFET repair (12% [n = 9] vs 9.5% [n = 8], P = 0.6). Extended-classic repair had higher risk of early death than limited repair (P = 0.0005) with no differ

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Author

Eric E Roselli; Benjamin Kramer; Emidio Germano; Andrew Toth; Patrick R Vargo; Faisal Bakaeen; Venu Menon; Eugene H Blackstone; Marc Gillinov; Gosta Pettersson; Edward Soltesz; Lars G Svensson; Daniel Burns; Kevin Hodges; Marijan Koprivanac; Francis Caputo; Sean Lyden; Levester Kirksey; Jon Quatromoni; Ali Khalifeh; Milind Desai; Vidyasagar Kalahasti; Brian Griffin; Richard Grimm; Paul Cremer; Bo Xu; Donald Hammer; Jay Ramchand; Maran Thamilarasan; Neha Quatromoni; Penelope Rampersad; Christine Jellis; Paul Schoenhagen; Michael Bolen; Christina Rigelsky; John Apostalakis; Andrew Bauer; Collaborators from Cleveland Clinic Aorta Center

Publisher

Oxford University Press (OUP)

Published

2023

Language

EN

Field

Medicine (Health Sciences)