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Frozen Elephant Trunk Does Not Increase Incidence of Paraplegia in Patients With Acute Type A Aortic Dissection

Sunday, April 14, 2019

Submitted by

Wei-Guo Ma

Source

Source Name: The Journal of Thoracic and Cardiovascular Surgery

Source URL: https://doi.org/10.1016/j.jtcvs.2019.03.097

Author(s)

Shi Sum Poon, David H. Tian, Tristan Yan, Deborah Harrington, Omar Nawaytou, Manoj Kuduvalli, Axel Haverich, Marek Ehrlich, Wei-Guo Ma, Li-Zhong Sun, Anthony L. Estrera, Mark Field

The International Aortic Arch Surgery Study Group assessed the safety of total arch replacement (TAR) with frozen elephant trunk (FET) for acute type A aortic dissection (ATAAD) with respect to the risks of operative mortality, stroke, and paraplegia.

Data from 978 patients who underwent total aortic arch replacement for ATAAD with or without FET placement were analyzed. In propensity-score matching, there were no significant differences between TAR plus FET versus isolated TAR in terms of permanent neurological deficits (11.9% versus 10.1%, p = 0.59) and spinal cord injury (4.0% versus 6.3%, p = 0.52). Post-hoc propensity-score stratification showed that FET was associated with a statistically significantly lower mortality risk (OR = 0.47, 95% CI 0.239-0.929, p = 0.03).

These results show that the use of FET for ATAAD does not appear to increase the risk of paraplegia in appropriately selected patients at experienced centers.