The frozen elephant trunk technique for hyperacute aortic dissection type A

Introduction. Acute aortic dissection is a current and urgent problem in modern cardiac surgery. In the early stages of the dissection, the surgeon is faced with the dilemma of choosing the volume of intervention from the ascending part reconstruction only or radically ascending and aortic arch replacement. Hybrid systems for one-stage reconstruction of the thoracic aorta are currently being actively developed. The Frozen Elephant Trunk (FET) technique allow us to replacement ascending and arch of the aortae combined with antegrade stent grafting into the descending aorta from the classical sternotomy access. This type of operation doesn’t increase the time of the intervention, there isn’t stage-by-stage reconstruction of the aorta, adequate blood flow in the descending aorta and aortic vessels is restored, and the risks of an adverse outcome are reduced.

Objective. To analyze the results of surgical treatment of acute aortic dissection type A, performed using the FET technique in a multidisciplinary surgical hospital – N.V. Sklifosovsky Research Institute for Emergency Medicine.

Material and methods. The research included 18 patients which were operated from 2022 to 2024 in acute stage of aortic dissection. All patients were operated using a hybrid technique FET.

Results. Multisystem organ failure developed in 5 patients (27.8%). Four patients (22.2%) required renal replacement therapy due to acute renal failure. In 38.9% of the subjects, prolonged artificial ventilation was complicated by pneumonia. Cerebral complications were observed in 6 patients (33.3%). Sepsis accompanied the course of the disease in 16.7% of cases. The 30-day mortality was 22.2%, in the study group.

Conclusion. Using the hybrid prosthesis allowed us to obtain relatively satisfactory results of reconstruction thoracic aortae in case of the acute dissection in the early postoperative period.

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