Frozen elephant trunk infection: to defrost or to debranch?. (24th December 2020)

• Record Type: Journal Article
• Authors: Nader, Joseph; Chabry, Yuthiline; Nazih, Houda; Caus, Thierry
• Is Part Of: European journal of cardio-thoracic surgery. Volume 60:Number 1(2021)
• Page Start: 191
• Page End: 193
• Publication Date: 2020-12-24
• Subjects: Aortic dissection -- Aortic arch -- Endovascular graft; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezaa466
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: Infections of frozen elephant trunk hybrid prosthesis (HP) are not well documented in the literature and their management is not standardized yet. We report herein the case of a 59-year-old patient who benefited from a Thoraflex™ HP aortic arch replacement for an acute type A aortic dissection. He presented a year later with a Staphylococcus aureus infection of the proximal part of this prosthesis. We performed a replacement of the proximal compound of the HP accompanied by a complete debranching of the 3 supra-aortic vessels with an inter-carotidal retro-oesophageal bypass. As we left in situ the endovascular graft within the descending aorta, a life-long antibiotic therapy was introduced. The postoperative follow-up was uneventful, and the patient discharged home 2 weeks after his surgery. As an alternative to a more radical redo surgery with major risk, a hybrid medical and surgical treatment of infected frozen elephant trunk could be considered.