Commentary: Technology and Technique

  • Dawn S. Hui
    Addresss reprint requests to Dawn S. Hui, MD. Department of Cardiothoracic Surgery, University of Texas Health San Antonio, 7703 Floyd Curl Drive, Suite 211L, San Antonio, TX 78229.
    Department of Cardiothoracic Surgery, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX.
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      Improvements in extended arch repair for acute type A aortic dissection come from incremental changes in technique as well as technological advancements.
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        • Fichadiya A
        • Gregory AJ
        • Kotha VK
        • et al.
        Extended-arch repair for acute type-A aortic dissection: perioperative and mid-term results.
        Eur J Cardiothorac Surg. 2019; 56: 714-721
        • Kazui T
        • Yamashita K
        • Washiyama N
        • et al.
        Impact of an aggressive surgical approach on surgical outcome in type A aortic dissection.
        Ann Thorac Surg. 2002; 74 (discussion S57-63): S1844-S1847
        • Easo J
        • Weigang E
        • Hölzl PP
        • et al.
        GERAADA study group. Influence of operative strategy for the aortic arch in DeBakey type I aortic dissection: analysis of the German Registry for Acute Aortic Dissection Type A.
        J Thorac Cardiovasc Surg. 2012; 144: 617-623
        • Hsieh WC
        • Kan CD
        • Yu HC
        • et al.
        Ascending aorta replacement vs. total aortic arch replacement in the treatment of acute type A dissection: a meta-analysis.
        Eur Rev Med Pharmacol Sci. 2019; 23: 9590-9611
        • Yan Y
        • Xu L
        • Zhang H
        • et al.
        Proximal aortic repair vs extensive aortic repair in the treatment of acute type A aortic dissection: a meta-analysis.
        Eur J Cardiothorac Surg. 2016; 49: 1392-1401
        • Helder M.R.K.
        • Schaff H.V.
        • Day C.N.
        Regional and temporal trends in the outcomes of repairs for acute type A aortic dissections.
        Ann Thorac Surg. 2020; 109: 26-33
        • Poon SS
        • Theologou T
        • Harrington D
        • et al.
        Hemiarch vs total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis.
        Ann Cardiothorac Surg. 2016; 5: 156-173
        • Shrestha M
        • Beckmann E
        • Kaufeld T
        • et al.
        Total aortic arch replacements with a 4 branched Frozen Elephant Trunk (FET) Graft in Acute aortic dissection (De[1]Bakey type I).
        Oper Tech Thorac Cardiovasc Surg. 2022; 27: 246-260
        • Shrestha M
        • Haverich A
        • Martens A.
        Total aortic arch replacement with the frozen elephant trunk procedure in acute DeBakey type I aortic dissections.
        Eur J Cardiothorac Surg. 2017; 51: i29-i34

      Linked Article

      • Total Aortic Arch Replacements With a 4 Branched Frozen Elephant Trunk (FET) Graft in Acute Aortic Dissection (DeBakey type I)
        Operative Techniques in Thoracic and Cardiovascular SurgeryVol. 27Issue 3
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          The “frozen elephant trunk” (FET) technique was developed by Karck et al., who modified Borst's ET technique by using a stent graft to secure the distal ET section. Working in collaboration with Vascutek Terumo, we in Hannover Medical School introduced the 4-branched hybrid FET graft In 2012 (Thoraflex Hybrid). However, the results after open aortic arch repair mainly depend on perioperative management and patient factors. Over the years, peri-operative management and operative techniques have evolved greatly contributing to better results.
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