Fenestrated and covered frozen elephant trunk technique for management of chronic aortic dissection. Issue 12 (28th September 2022)

• Record Type: Journal Article
• Authors: Okamura, Homare; Kitada, Yuichiro; Wada, Yohnosuke; Adachi, Hideo
• Is Part Of: Journal of cardiac surgery. Volume 37:Issue 12(2022)
• Page Start: 5487
• Page End: 5489
• Publication Date: 2022-09-28
• Subjects: aortic dissection -- distal stent graft‐induced new entry -- fenestration -- frozen elephant trunk; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.16974
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Background: Reintervention for residual dissection after repaired type A aortic dissection remains challenging. When a frozen elephant trunk (FET) is used, the incidence of distal stent graft‐induced new entry (d‐SINE) is reportedly high in chronic dissection. Aims: We report a case of successful redo arch repair using fenestrated and covered FET techniques for chronic residual aortic dissection. Methods: After the arch was transected proximal to the left subclavian artery (LSCA), and a modified FET prosthesis, in which the distal edge of the FET was covered, was deployed. A fenestration was created in the FET on the LSCA aspect. Results: The postoperative course was uneventful. Discussion: The distal edge of the FET was covered to prevent d‐SINE. Creation of a fenestration on the FET eliminates the need to reconstruct the LSCA. Conclusion: The fenestrated FET technique simplifies redo arch repair and the covered FET technique can potentially prevent d‐SINE.